Archived: Parklands Court Care Home

The service provides accommodation, nursing and personal care for up to 163 people. The home is split into six different units. Harrison and Collins can accommodate up to 30 people. Marlborough can accommodate up to 24 and Elmore which is a unit off Marlborough can accommodate up to 16 people. Clarendon can accommodate up to 33 and Samuel up to 28 people. All the units have their own separate living and dining spaces. There were 152 people living in the home at the time of our inspection visit.

Parklands Court Care Home was registered under the provider name of BUPA Care Homes (CFH Care Limited) up until February 2017. We were notified in December 2016 that the provider intended to simplify its structure and applied for all of its registered locations across the UK (which at that time were registered across 13 different legal entities) to transfer over to just two legal entities. This meant that Parklands Court Care Home became newly registered under the provider name Bupa Care Homes Limited in February 2017. Therefore, this was the provider's first inspection at this location since newly registering with us in February 2017. The inspection history for the location under the previous provider was used to inform the planning of this inspection because the management of the service at provider level had remained consistent.

Our last comprehensive inspection of this location took place in January 2016 and found improvements were required to ensure people always received a service that was safe, effective, caring and responsive. The reports from our previous inspections are available in the full history of inspection reports, which can be found in the previous provider's archived records for this location on our website at www.cqc.org.uk

At this inspection, we identified a number of Regulatory Breaches. The overall rating for this service is ‘Inadequate’ and the service has therefore been placed into ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

At the time of this inspection the manager had been in post for three months and was in the process of completing their registration with us. 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 provider had insufficient numbers of staff effectively deployed across all the different units to ensure people were safe. Staff were not consistently available to respond to people who needed reassurance to improve their well-being. The deployment and management of staff meant there were times when there were not enough 'eyes and ears' to monitor people safely as they walked around the home and interacted with each other.

Risks to people’s health and safety were not always assessed and planned for. Some risk management plans had not been updated to reflect changes in people’s needs to ensure people received consistent support to keep them safe. Improvements were needed in the management of medicines so people always received their medicines safely and as prescribed.

Staff and the manager knew how to report allegations of abuse. However, we identified occasions when people had been pushed over or hit by others which had not been reported to the local authority or ourselves as potential safeguarding incidents.

The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received an induction and on-going training to carry out their role effectively. The manager had identified staff required further training to ensure they had the awareness and understanding to support people living with dementia.

People were not always appropriately supported when they had been identified as being at risk of malnutrition. Records to ensure people had enough to eat and drink to maintain their health were not always completed accurately. Where a need was identified, people were referred to other healthcare professionals to improve their health and wellbeing.

Staff demonstrated their understanding of the Mental Capacity Act 2005 and supported people to make as many of their own decisions and choices as possible. Staff sought people's consent before supporting them. Mental capacity assessments had been completed where it was believed that a person did not have the capacity to consent to a specific decision.

The provider had identified people whose care plans contained some restrictions to their liberty and had submitted the appropriate applications to the authorising authority in accordance with the legislation.

Staff were kind and caring but on some units staffing levels meant staff only had the opportunity to show kindness and care when they undertook a task or intervened in a situation. Staff were focussed on tasks rather than providing individualised care. When staff did engage with people, they were patient and reassuring. People were not always supported with personal care in a timely way to promote their dignity.

People did not always have interesting things to do on a regular basis. When people living at the home lacked stimulation, they could become unsettled. People were encouraged to maintain relationships important to them and visitors felt welcomed into the home.

People’s experiences of care depended on which unit they lived on. Whilst some people’s experiences were positive, other people experienced a level of care that fell below recognised standards and did not promote their health and wellbeing. The provider’s quality checking arrangements were not consistently robust and effective in identifying, making and sustaining improvements in the quality of care delivered at the home. Managerial changes had led to inconsistency in leadership and this had impacted on the quality of care people received. Staff morale was low because they did not always feel listened to.

A new manager was open about the challenges they faced and the improvements needed to ensure the standard of care was consistent through the home. They had identified where improvements were needed and were committed to providing staff with the skills and confidence to provide safe and effective care.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.