CQC report explained · a residential care home
What the CQC found at Parkview
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments generally identified known risks and gave staff guidance. Medicines, staffing, safeguarding and infection control were found to be managed safely, although one community access risk assessment needed improvement and was corrected during the inspection.
- Effective?
- Good
- Staff received training, regular supervision and annual appraisals. People’s consent was sought and respected, and their health, food and drink needs were monitored.
- Caring?
- Good
- Staff knew people well and were observed to be kind, calm and respectful. People’s privacy, dignity, independence, equality and cultural needs were supported, although people gave mixed views about privacy.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People had access to activities, community opportunities and suitable communication support, and complaints were investigated with positive outcomes.
- Well-led?
- Requires improvement
- Audits, incident reviews and feedback systems helped identify and address problems. However, the registered manager did not have enough support and time to complete all management tasks promptly.
What inspectors found, April 2018
Rated Good overall, but inspectors found the home needed better management support and rated it Requires Improvement for being well-led.
This was an unannounced comprehensive inspection on 5 and 9 March 2018. Inspectors spoke with people living at the home, a relative, staff, the cook, the registered manager and the provider. They reviewed care plans, medicines records, staff files, complaints and management records.
The home was rated Good for being safe, effective, caring and responsive. Inspectors found improvements in risk assessments, staff training, supervision, medicines management and quality checks since the previous inspection in November 2016.
The overall rating improved from Requires Improvement to Good. However, the home was rated Requires Improvement for being well-led because the registered manager did not have enough support and time to complete all responsibilities promptly. Inspectors recommended a review of the management structure.
Safer risk management
The home had improved its risk assessments and gave staff clearer guidance. Staff also received training and support to respond to distressed or challenging behaviour.
“Systems and processes in place identified risks and gave staff clear guidance on how to mitigate those risks.” from the report
Medicines handled safely
Medicines records were up to date, stocks and balances were accurate, and daily audits were used to identify errors quickly.
“People's medicines were managed safely. Records indicated no errors or omissions.” from the report
Kind and respectful care
Inspectors saw staff speaking calmly and supporting people with compassion. People were encouraged to make choices and remain independent.
“People received compassionate and caring support from staff that knew them well and treated them with dignity and respect.” from the report
Personalised support and activities
Care plans included people’s histories, preferences and health needs. People took part in activities such as cooking, exercise, meals out and community visits.
“People's care plans were person centred and detailed sufficient information about their life history, health, medical and mental health needs.” from the report
Complaints were followed up
The two official complaints recorded in the previous year had been investigated and had reached positive outcomes. People could also raise concerns informally.
“The registered manager responded to official complaints in a timely manner, seeking a positive resolution for all parties.” from the report
Limited management support
needs fixingThe registered manager was responsible for both managing the home and providing hands-on support. Inspectors found this left insufficient time to complete some tasks promptly.
“The registered manager did not always have effective support and time to carry out his role and responsibilities.” from the report
End of life plans not complete
needs fixingPeople’s wishes about end of life care had been recorded, but important details were missing. The manager said this work was being completed across the provider’s services.
“People's wishes in relation to the end of life care they wanted to receive was documented, however was not sufficient.” from the report
One community risk assessment needed more detail
needs fixingOne risk assessment did not give staff enough guidance to keep a person safe when accessing the community. The home reviewed it and added clearer guidance during the inspection.
“We identified one risk assessment that did not contain adequate information and guidance for staff to keep the person safe when accessing the community.” from the report
- 01What changes have been made to the management structure since this inspection, and who supports the registered manager?
- 02Have all residents’ end of life care plans now been completed, including their wishes about who should be notified and burial or cremation?
- 03How are community access risks assessed and reviewed for each person?
- 04How do you check that staff continue to receive regular supervision, appraisals and training?
- 05How have concerns about activities, laundry and food raised in the quality questionnaires been addressed?
This was an unannounced comprehensive inspection covering all five key questions and the care, accommodation and management of the home. This explanation was written from the published report of 17 April 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2017
Crownwise Limited - Parkview was rated Requires Improvement; inspectors found caring support but unsafe staffing and weaknesses in risk management, staff support and oversight.
This was an unannounced comprehensive inspection on 15 and 18 November 2016. Inspectors spoke with people, staff, the registered manager and health professionals. They observed care, reviewed six care records, medicines records for all 14 people, staff files and management records.
The home had improved its medicines management since the previous inspection. Medicines were given as prescribed, stored securely and recorded properly. However, staffing was still not enough at times, risk plans did not always give staff clear instructions, and staff could not show they knew how to manage some difficult situations safely.
Staff did not receive regular supervision or appraisals. The home's checks did not always identify these problems or show that learning from incidents was taking place. Care was rated Good for being caring and responsive, but Safe, Effective and Well-led were rated Requires Improvement.
Medicines were managed safely
The home had fixed the medicines problem found at the previous inspection. Inspectors found medicines were given as prescribed, stored securely and fully recorded.
“We observed staff administer medicine at lunchtime and saw that people received their medicines as prescribed.” from the report
Kind and respectful care
People said staff were kind and helpful. Inspectors saw staff listen, offer reassurance and respect privacy, dignity and personal choices.
“People were treated dignity and their privacy, choices were respected by staff.” from the report
Individual support
Care plans covered people's mental and physical health, backgrounds, relationships, interests and goals. People were supported to be independent and take part in activities.
“People received care tailored to meet their individual needs.” from the report
Safeguarding awareness
Staff understood how to recognise and report abuse. Records showed safeguarding concerns were reported and investigated according to the home's procedures.
“Staff were aware of the different types of abuse and were confident in following the correct procedure in reporting suspected abuse.” from the report
Not enough staff
seriousStaff were often busy and rushed. Inspectors found this meant people sometimes had to wait and did not always receive the time and support they needed.
“Staffing levels were not always sufficient to safely meet the needs of people.” from the report
Risk guidance was incomplete
seriousSome risk assessments did not give staff clear instructions. Inspectors were also concerned that staff could not demonstrate how to de-escalate some situations safely.
“Care records did not always contain clear guidelines for staff to follow to manage identified risks.” from the report
Staff support and competence
seriousStaff had not received regular supervision or appraisals. Although training had been provided, staff could not always show they understood how to use it in practice.
“Staff did not receive adequate and regular support, supervision, appraisal and training necessary to enable them carry out their duties effectively.” from the report
Weak quality oversight
seriousAudits did not always find missing care information or missed supervision and appraisals. The home also did not have a system for staff to reflect on incidents and learn from them.
“The systems and processes in place were not robust enough to identify pitfalls in the quality and safety of the service provided to people” from the report
- 01How many staff are on duty now, and how do you make sure there is enough time for people to receive activities and support outside their basic needs?
- 02How are risk plans kept up to date, and what clear guidance is available when someone becomes distressed or behaves aggressively?
- 03How do you check that staff understand and can apply their training on managing challenging behaviour?
- 04How often do staff now receive supervision and appraisals, and how is this recorded?
- 05What changes have been made to ensure incidents are reviewed and used to improve practice?
This was an unannounced comprehensive inspection covering all five key questions and checking whether earlier breaches relating to staffing and medicines had been addressed. This explanation was written from the published report of 20 January 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Parkview
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- April 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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