Archived: Gorton Parks Care Home

Updated 15 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 and 20 April 2016 and was unannounced. The inspection team consisted of two adult social care inspectors, a specialist adviser in dementia and an expert-by-experience on the first day of the inspection. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience of services for older people. One adult social care inspector returned on the second day of the inspection.

We also reviewed the information we held about the service including notifications the provider had sent to us. We contacted the local Healthwatch organisation and the local authority’s commissioning team, Manchester Clinical Commissioning Group (CCG) and Manchester City Council’s safeguarding and infection control teams to obtain their views about the service. The safeguarding team had one safeguarding issue currently being investigated. We were already aware of this as the registered manager had previously notified the CQC. The other organisations we contacted did not express any current concerns about the service provided in Gorton Parks Nursing and Residential Home.

During the inspection we carried out observations in each of the four units in the service, including over the lunchtime period. We spoke with 13 people who used the service, six visiting relatives, two visitors from a local church, a GP, a visiting health professional and a social worker. We also spoke with the manager, the clinical lead, three unit managers, one registered nurse, 14 members of care staff, an activity coordinator, the chef, one housekeeper and two laundry assistants. After the inspection we contacted a member of the continuing healthcare team from the Central Manchester CCG.

We looked at the care records for 12 people who used the service and the medication records for 19 people. We also looked at a range of records relating to how the service was managed; these included seven staff personnel files, staff training records, quality assurance systems and policies and procedures.

Updated 15 June 2016

This inspection took place on 19 and 20 April 2016 and was unannounced.

Gorton Parks Nursing and Residential Home was last inspected in July 2014 when we identified four breaches of the regulations we reviewed; these related to guidelines for managing challenging behaviour, lack of stimulation for people living with dementia, acting in accordance with the Mental Capacity Act (2005) (MCA) and having effective quality audit systems in place for the service.

Following the inspection in July 2014 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. Part of this inspection was undertaken to check whether the required improvements had been made. We found improvements in all four areas.

Gorton Parks Nursing and Residential Home is owned by BUPA Care Homes. The service consists of four 30 bedded units Melland House, Abbey Hey, Sunnybrow and Debdale. Part of the Debdale unit and a fifth unit on the same site are contracted to the NHS for re-ablement services for people discharged from hospital. They were not part of this inspection; being inspected by the CQC hospitals directorate. Each unit specialises in either nursing or residential care. Each unit has a lounge, dining area, a conservatory, a smoke room and a kitchenette. All bedrooms are single with no en-suite facilities. Accessible toilets and bathrooms are located near to bedrooms and living rooms.

The service had a registered manager in place. 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.

People told us they felt safe in the service and had no concerns about the care and support they received. They told us staff were always kind and caring. Staff had received training in safeguarding adults and knew the correct action to take if they witnessed or suspected abuse. Staff were confident that the unit managers, clinical lead and registered manager would act on any concerns raised.

We noted improvements had been made to the risk management and behaviour management plans. However we found that behaviour management plans were not completed in the care plans we looked at on one of the units.

A process was in place to recruit suitable staff; however records of staff recruitment did not fully evidence that the people who used the service were protected from the risks of unsuitable staff being recruited. We found the reasons for gaps in three people’s employment history had not been recorded. The registered manager told us they would add this as a question for candidates at their interview. Care staff received the induction, training and supervision they required to be able to deliver effective care We saw, and were told, that the staffing levels were sufficient on each unit for staff to respond to people’s requests for support in a timely manner. Additional staff were being recruited to cover for staff on annual leave or training and reduce the need for the use of agency staff.

We saw that medicines were managed safely throughout the service. People told us that they received their medicines as prescribed. Protocols were in place to guide staff as to when ‘as required’ medicines were to be administered. More detail was required in the protocols on two units to clearly describe how staff would recognise the signs that the person was becoming agitated and required an ‘as required’ medicine to be administered.

All areas of the home were clean. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply. Regular checks were in place of fire systems and equipment. We found that some checks had not been completed in early 2016 due to the recruitment of a new maintenance person. We were assured the outstanding checks would be completed by May 2016.

People told us they always received the care they needed. Care records we reviewed showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk. Care records had been regularly reviewed to help ensure they accurately reflected people’s needs.

Systems were in place to help ensure people’s health and nutritional needs were met. Records we reviewed showed that staff were proactive in contacting relevant health professionals to ensure people received the care and treatment they required.

We noted that improvements had been made for assessing whether people were able to consent to their care and treatment. The manager was aware of the action to take to ensure any restrictions in place were legally authorised under the Deprivation of Liberty Safeguards (DoLs). However we found that best interest decision forms had not been consistently completed in all the units.

A programme of activities was in place to help promote the well-being of people who used the service. Records we reviewed showed people were supported to access activities on both a group and individual basis. Additional activity officers had been recruited since our last inspection. We saw that two of the three activities officers had been off work for an extended time. Activities had reduced during this period.

The service had an advanced care planning process in place to support people at the end of their lives. We were told by a visiting GP the end of life support people received was excellent, with people being able to be supported within the service, rather than be admitted to hospital, if they chose to. Close relations had been built with the GP practice; the home is in the process of registering 48 people with nursing needs with the practice.

There were effective systems in place to investigate and respond to any complaints received by the service. All the people we spoke with told us they would feel confident to raise any concerns they might have with the manager.

We noted there were a number of quality audits in the service; these included medicines, care records and the environment. Action plans were completed following the audits. Monthly statistics were compiled for monitoring purposes on a range of areas; for example nutrition, safeguarding referrals and hospital admissions.