Park House Nursing Care Centre

Updated 2 December 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 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

Park House Nursing Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Park House Nursing Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 21 August 2023 and ended on 3 October 2023. We visited the service on 21 August 2023.

What we did before the inspection

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service. We spoke with 7 relatives about their experience of care provided.

We spoke or received written feedback from 19 members of staff including the registered manager, nominated individual, lead nurse, nurses, care workers, activity providers, head cook and domestic staff. We also spoke or received written feedback as part of the inspection from 5 professionals who worked with the service. We conducted observations in communal areas to observe interactions between people and staff and the care and support offered. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 2 December 2023

About the service

Park House Nursing Care Centre is a residential care home providing personal and nursing care to up to 30 people. The service provides support to people who may be living with dementia and physical disabilities. At the time of our inspection there were 24 people using the service.

People were supported in an extended Grade II building with accommodation over two floors. People had access to communal areas consisting of a lounge, dining room, courtyard, community room and well-tended gardens.

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

People were at risk of poor care and support because governance systems were not effective and needed strengthening. Although audits were taking place they had failed to identify and address the issues we found during our inspection, in relation to care planning, infection prevention and control (IPC) and medicines.

People’s medicines were not always managed safely. We identified concerns relating to storage, stock levels and medicines records.

We found no evidence people had been harmed. However, risk management of ‘high risk’ medicines required further development.

The provider did not have effective safeguarding systems in place to help protect people from the risk of abuse.

The registered manager had not ensured safe recruitment practices were being followed.

Staff training records showed gaps in essential training. And there was no evidence to show that staff had completed training to meet people’s specialist care needs. For example, Motor Neurone Disease.

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

Care plan quality was inconsistent and required further development.

There were enough staff to meet people’s care and support needs. Staffing levels were increased if people required additional care.

People were protected from the risks of infection. We saw staff wearing personal protective equipment (PPE) to reduce the risk of spreading infections.

People’s needs had been assessed before they started using the service; and people told us they were involved in making decisions about their care.

Staff treated people with respect and upheld their privacy and dignity. Staff knew people well and encouraged them to be as independent as possible.

The service worked with a wide range of key organisations who were also involved in people’s care.

People and staff were positive about the registered manager and nominated individual. Staff said they were both approachable.

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 11 December 2018).

Why we inspected

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

Enforcement and Recommendations

We have identified breaches in relation to people’s safe care and treatment, staff training and support and the overall governance of the service at this inspection.

We have also made a recommendation the provider considers current guidance in relation to safeguarding processes, recruitment of new staff and supporting people to make their own decisions in line with consent to care and treatment.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.