Parris Lawn

Updated 30 November 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Parris Lawn is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not working at the home at the time of the inspection. An interim manager and senior managers from the provider organisation were currently responsible for the day to day running of the home.

Notice of inspection

The first day of the inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return before this inspection because we inspected earlier then we planned. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with twenty people who used the service and ten relatives about their experience of the care provided. We spoke with twenty two members of staff. This included a regional manager and senior operations manager from the provider organisation.

We spent time observing in areas throughout the home and could see the interactions between people and staff. We watched how people were being cared for by staff in communal areas. This included the lunchtime meal and activities.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at recruitment procedures and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The management team updated us with changes that they had made. This included updated care plans, training and supervision records, and updates to ongoing investigations. We contacted two professionals who regularly visit the service.

Updated 30 November 2019

About the service

Parris Lawn is a purpose-built nursing home that provides personal and nursing care to up to 62 people. There were 55 people living at the home when we inspected. People were living with a range of needs such as stroke, heart disease, diabetes and dementia. Some people were living with a range of needs associated with the frailties of old age.

People’s experience of using this service and what we found

CQC had been contacted about concerns relating to the medicine systems, staffing levels and end of life care at Parris Lawn. We contacted the provider so that they could take immediate action to make sure everybody living there was safe. The provider told us what they had done to address these concerns. They shared an action plan with us that identified further areas of concern, this included complaints not being responded to appropriately, people’s records not containing all the information staff may need and staffing numbers. The action plan showed, what action was being taken, who was responsible, and when this should be completed by.

At the inspection there was evidence of significant work having taken place to improve and develop the service. This took into account the views of people, visitors and staff. A new management team was in place, they were reviewing all aspects of the service and had already provided training for staff and had arranged meetings with people and relatives to share their plans. There was a clear commitment from the management team and staff to improve and develop the service. Further time is needed to fully embed the changes into everyday practice.

Medicines were well managed, and people were supported to receive their medicines safely, when they needed them. There were enough staff working to provide the support people needed. Recruitment procedures helped to ensure only suitable staff worked at the home.

People received care and support that they needed. This was because regular staff knew them well and agency staff were supported by the regular staff. There was an activity program and people were seen to be enjoying themselves throughout the day.

Risk assessments provided guidance for staff about individual and environmental risks. Staff understood the risks associated with the people they supported. People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns.

People were supported by staff who treated them with kindness and compassion. People were enabled to make their own decisions and choices about the care and support they received.

People were supported to enjoy a variety of food and drink of their choice. Nutritional assessments were completed to help ensure people received the appropriate diet. There was a training program, and this helped to support staff to have the knowledge and skills to look after people effectively. Nurses received clinical training to ensure they could meet people’s specific needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to maintain and improve their health through regular contact with external health professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 1 September 2018). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

The inspection was prompted due to concerns received about medicine safety, staffing numbers and the care people received, this included end of life care. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Parris Lawn on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.