Park View

Park View is a care home in Salford which is registered with CQC to provide care for a maximum of 9 people. There were 8 people using the service at the time of the inspection.

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

Not all risks were effectively managed at the home and some safeguarding concerns were not always reported to the local authority for further investigation. Accidents and incidents were monitored, although trends and certain repeated incidents were not always identified.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Staff supervisions did not always take place consistently.

Although audits were undertaken at the service, they had not identified the concerns found during this inspection. Staff and resident meetings did not take place consistently and recent satisfaction surveys had not been sent to gather people’s views.

People living at the home and relatives said they felt the service was safe. There were enough staff to care for people safely and correct staff recruitment procedures were followed.

People received enough to eat and drink and were supported to maintain good health and staff supported people to attend appointments where necessary.

We received positive feedback about the care provided. Staff were described as kind and caring and treated people well.

Systems were in place to manage complaints. The feedback we received was that the care was person centred and that people were able to participate in hobbies and activities of their choosing.

Rating at last inspection

The last rating for the service was good (Published October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Park View on our website at www.cqc.org.uk.

Enforcement and recommendations

We identified a breach regarding good governance and have made recommendations regarding risk management, MCA assessments and safeguarding referrals.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Park View is located in Salford, Greater Manchester and is operated by Potensial Limited. The home provides accommodation and personal care to people living with a mental health diagnosis and is registered with CQC to provide care for up to 9 people. There were 8 people living at the home at the time of our inspection.

We found the following examples of good practice:

Visiting health professionals were required to demonstrate they had received both doses of the COVID-19 vaccine on arrival to the home, however this information was not documented on the screening questionnaire used. We asked the manager to include this information.

Zoning arrangements were used if people needed to self-isolate in certain areas of the home, such as bedrooms. Testing arrangements were in place for both staff and people using the service and were followed.

All staff working at the home had received their COVID-19 vaccination which was a condition of employment. Appropriate arrangements were in place for new admissions, such as requesting confirmation of a negative COVID-19 test and completing a period of self-isolation.

Enough PPE was available and staff wore it at all times during our visit. The home was clean and tidy, with any cleaning duties carried out by support staff.

There were enough staff to care for people safely, with staff receiving additional infection control training during the pandemic. Both agency and bank staff were used to fill any gaps in rotas where regular staff were unavailable.

Risk assessments were in place where certain groups may be at higher risk of contracting COVID-19. An appropriate infection control procedure was in place, with specific reference to COVID-19. Regular infection control audits were undertaken to ensure standards were maintained.

Further information is in the detailed findings below.

Park View is a care home located in Salford and accommodates up to nine adults who have mental health and acquired brain injury related conditions. At the time of the inspection there were nine people using the service. The service is located in the Seedley area of Salford and is close to local amenities and transport routes for Greater Manchester.

We last inspected Park View in January 2016, where the home was rated Good overall and for each key question we inspected against. We found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good overall. We have however have made two recommendations within the Safe domain of this report.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 as result of the care and support they received and staff understood their responsibility with regards to safeguarding people from abuse.

Staff were recruited safely, with appropriate checks undertaken before they commenced employment, however we have made a recommendation about these could be strengthened in future.

The building was being appropriately maintained, although we have made a recommendation regarding acting on any follow up repairs in a timely way.

There were enough staff available to care for and support people safely.

People had detailed risk assessments in their support plans and the service maintained a log of any accidents and incidents which had occurred, which detailed any follow up actions taken.

Appropriate systems were in place to manage people’s medication safely.

Staff told us they received enough training, induction, supervision and appraisal to support them in their role.

People received enough to eat and drink and we found any specific dietary requirements were adhered to.

The people we spoke with told us they were happy with the care and support they received and described staff as kind and caring.

The service was meeting the requirement of the accessible information standard (AIS).

The service used the recovery star as part of people’s care and support. The recovery star is an outcomes measure which enables people to measure their own recovery, with the help of staff. People’s care plans were centred around the recovery star, so staff could monitor their progress.

Complaints were investigated and responded to appropriately.

People had access to learning and development courses within the local community and these were also discussed during key worker reviews. Holidays and trips away were supported by staff if this was what people wanted to do.

There were systems in place to seek feedback from people using the service through satisfaction surveys. Residents meetings also took place for people to share their views.

A range of internal auditing systems were in place at both managerial and provider level so that the quality of service could be monitored effectively.

Policies and procedures were in place so that staff could seek advice about areas effecting their work if they needed to.

Park View is located in Salford and provides 24 hour support to people with mental health and learning difficulties. The home is owned by Potensial Limited and is registered with the Care Quality Commission (CQC) to provide care and support for up to nine people.

We carried out our last inspection of Park View in August 2013. At this inspection, we found the service was meeting all standards assessed at that time.

A new manager had started working at the service in September 2015, and was not yet registered with the Care Quality Commission. They told us their application was underway. 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 living at the home told us they felt safe. The staff we spoke with demonstrated a good understanding of safeguarding and whistleblowing procedures and how to report concerns.

Staff recruitment procedures were safe. We saw appropriate checks were undertaken before staff began working at the home, such as seeking written references and undertaking DBS (Disclosure Barring Service) checks.

We found people had risk assessments in their support plans detailing control measures to help keep people safe. The service encouraged positive risk taking to promote people’s independence, such as encouraging people to use public transport independently, or walking into town on their own.

We found people’s medication was given to them safely. The people we spoke with told us they received their medication at the prescribed time. We found medication was stored in a secure room and only staff involved with administration had access. People had their own individual medication administration records (MAR) which we saw were signed by staff when medication had been taken. Where people required PRN (as required) medication, there were clear guidelines for staff to follow about when this should be given.

We looked at the staff rotas to see how the service ensured there were sufficient numbers of staff to meet people’s needs and keep them safe. We found the service had sufficient skilled staff to meet people's needs, and people who lived at the home confirmed this stating there were enough staff to support them. The staff we spoke with told us they were satisfied with the current staffing levels at the home.

The staff we spoke with told us they had enough training available to them and felt well supported to undertake their work. Staff told us they undertook an induction when they first started working for the service and received regular supervision where they could discuss certain aspects of their work with their manager.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. At the time of the inspection, there was nobody living at Park View who was subject to a DoLS (Deprivation of Liberty Safeguards). People were able to go out when they wanted and into the local community unaccompanied. We saw staff had received eLearning training on MCA and when questioned, staff demonstrated an understanding of circumstances in which people may be restricted of their liberty.

People said they had enough to eat and drink and were given different choices and alternatives. Where able, people, were given support by staff to prepare their own meals. We were told an evening meal was always prepared by staff and that people who lived at the service were able to contribute where possible. People were encouraged to make their own breakfast and lunch in order to maintain their independence and develop skills in this area.

The people we spoke with were positive about the care and support they received from staff, and several people reported their mental health had improved since living at Park View.

There was a complaints policy and procedure in place, which explained what people needed to do, if they were unhappy with any aspect of the service. People told us they felt complaints would be handled appropriately, although they hadn’t needed to make a complaint since living at the home.

People had a range of in house and community activities available to them. Each person who lived at the home was able to access the community independently, which was something they said they enjoyed.

Both staff and people who lived at the home felt the service was well-led and that the management were approachable. Staff also spoke of a positive culture whilst working at the home and told us they enjoyed their work.

There were systems in place to monitor the quality of service at the home. This included audits of support plans, staff personnel files, medication, the environment and peoples’ finances. We saw that action was taken if any discrepancies were found. Accidents and incidents were also monitored closely through the use of an internal system. We saw prevention measures had been implemented to avoid future re-occurrences.

Overall, people told us they were happy living at Park View and felt well supported. Comments from people who used the service included; 'It's ok here. The staff support me well' and 'We're allowed to do as we please really' and 'I like living here. My son visits me often' and 'The staff are good. They prompt me to eat which is really important' and 'You can have your freedom here. I need that in my life at the minute'.

During our inspection we looked at what methods were in place for people to provide consent to their care and support, and we found there were effective systems in place.

We looked at how people living at Park View received their medication and looked at the systems in place to ensure this was done safely. One person said to us;' I get my medication on time. The staff have already given me my tablets this morning actually'.

We looked at three staff member files to ensure members of staff had been recruited safely and we found appropriate checks had been made before commencing employment.

We found there were systems in place to monitor the quality of service provision effectively which included the use of audits, surveys and regular staff meetings.

We found that people within the home were generally happy with their care and were positive about the staff.

We found the service had recently appointed a new manager.

During the visit we spoke to five people who used the service and three staff. We saw that staff were polite and friendly and caring toward the people who used the service.

People told us: " I like it here, my room is my space". " We can come and go as we please providing we tell someone where we are going". " I'm unwell at the moment and they look after me well".

Staff told us: " It's a challenge but I enjoy it". " I love my job here".