Archived: Parkwood House

This inspection was carried out on 13 October 2016 and was unannounced. This was a comprehensive inspection and included an inspection of the previous breaches of legal requirements. The service provided accommodation and personal care for up to 13 adults with learning disabilities. There were 7 people living in the service when we inspected.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again and kept under review. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

There was a registered manager in place when we inspected the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager and provider had made significant changes to the service since the last inspection and in particular to the way risk were managed to prevent harm to people. Incidents and accidents were also appropriately managed to reduce or prevent reoccurance.

People received a service that was safe and relative’s felt that their loved one was safe. Systems were in place to protect people from the potential risk of abuse. Staff had access to an up to date safeguarding adult’s policy. Staff had received training about protecting people from abuse and knew what action to take if they had any concerns. Accidents and incidents involving people had been recorded, assessed and reviewed. Immediate action was taken by the provider following a serious incident previously.

Risks to people’s safety had been assessed and recorded with measures put into place to manage any hazards identified. The premises had been maintained to ensure the safety of people. Risks to people’s safety had been assessed and measures put into place to manage any hazards identified. The premises were maintained and checked to help ensure people’s safety. People’s safety in the event of an emergency had been assessed, recorded and reviewed.

People received support and assistance from enough staff to meet their assessed needs. There were enough staff on duty with the right skills to meet people’s needs. Staff had been trained to meet people’s needs. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People received their medicines safely and when they needed them. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely. People were supported to remain as healthy as possible with the support of healthcare professionals.

Staff had received sufficient training to meet people’s needs including any specialist needs. New staff received an induction before starting to work at the service. Staff received support and guidance from the registered manager to fulfil their role in meeting people’s needs. Staff said they were encouraged to discuss ideas and suggestions they had to improve the service.

People’s needs had been assessed to identify the care they required. Care and support was planned with people and their relatives and reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff about how to meet people’s needs including any specialist support needs. People were given food and drink that they enjoyed and had chosen. People were supported to maintain their nutrition and hydration. Healthcare professionals were involved if people were at risk of malnutrition or dehydration.

People participated in activities of their choice within the service and the local community. There were enough staff to support people to participate in the activities they chose with staff allocated to particular activities. People and their relatives were involved and asked for suggestions of ways the service could be improved, these were acted on. People and their relatives had access to a compliant policy and procedure. Systems were in place to monitor the quality of the service being provided to people.

People’s capacity to consent had not always been assessed as per the Mental Capacity Act 2005. Some decisions had been made for people without their consent and without the principles of the Act being followed. Staff offered people choices and gained their consent prior to offering any support. Staff were kind and caring towards people and took appropriate action to maintains people’s privacy and dignity. We have made a recommendation about this.

Systems were in place to monitor the quality of the service being provided to people. External governance systems were now in place to ensure the service continued to maintain and improve the quality of the service. Records were not always stored safely and securely. We have made a recommendation about this.

When we carried out our inspection there was no registered manager in post. We were informed that the registered manager had left the service two months prior to our visit. The provider had appointed a supporting manager to manage the service. The supporting manager had been in post for two weeks at the time of our inspection.

We considered our inspection findings to answer the five questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found. This summary is based on our findings during the inspection, discussions with people/representatives using the service, staff supporting people, the management team and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

The service was safe. There were processes in place to make sure that managers and staff learnt from events such as complaints, concerns, whistleblowing and investigations.

Is the service effective?

The service was effective. The provider had an effective complaints procedure in place. People and their relatives were informed of the procedure and their right to complain in a format that suited their needs.

Is the service caring?

The service was caring. People's care plans were updated following complaints and contained the information that staff needed to give people the care and support that they needed.

Is the service responsive?

People and their relatives knew how to make a complaint if they were unhappy. People and their relatives could be sure that their comments and complaints would be listened to and acted on effectively.

Is the service well-led?

We found that the provider recorded, investigated and resolved complaints appropriately and took action to ensure that changes were made as a result of complaints received about the service.

The service had identified areas in which people were particularly vulnerable and had put risk assessments and actions in place to address these. Staff we spoke with were able to tell us about the types of abuse and how they would report it. Most, but not all staff had received safeguarding training.

We found that the service was clean and hygienic. Cleaning was carried out by staff to a daily schedule which ensured that jobs were regularly completed and dirt was unable to build up. There was an effective system in place to control the risk of the spread of infection.

A range of regular audits had been undertaken by the service and we found evidence of the learning that had arisen from these. We saw that people had been asked their opinions of the service in a survey and that they and their relatives could nominate a staff member for an 'employee of the month' award.

We found that people and their relatives had not been made aware of their right to complain and the method for doing so, in a suitable manner or format.

We found that people were involved in their care and they were supported in a kind and sensitive manner. However, we found that the provider did not always have contingency plans to ensure that there was a priority placed on ensuring people attended activities as planned.

People enjoyed meals throughout the day and were able to assist in their preparation. One person said, "I like helping in the kitchen. Chips and pork pies are my favourite".

People were supported by staff who had been recruited fairly, taking into account their experience and knowledge.

We found that the premises continued to be poorly maintained and that the provider was not responding to maintenance issues in a prompt manner.