CQC report explained · a nursing home
What the CQC found at Park View
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, suitable risk assessments and clear safeguarding procedures. Medicines were generally managed safely, but some decision forms did not match changed prescriptions and medicines disposal records were not appropriate.
- Effective?
- Good
- Staff had suitable training, regular supervision and a good understanding of the Mental Capacity Act. People's health, nutrition, hydration and contact with health professionals were supported.
- Caring?
- Good
- Inspectors saw kind and compassionate relationships. People were treated with dignity, involved in decisions and supported to be as independent as possible.
- Responsive?
- Requires improvement
- Care plans were not always updated or easy to follow, so staff might not have accurate information about people's needs. Some people were also left without meaningful activities at times, although the home had recruited another activities co-ordinator after the inspection.
- Well-led?
- Good
- The acting manager was seen as approachable and supportive, and there were systems for feedback, checks and improvement. Care plan and risk assessment audits were not being completed as often as the home's policy said.
What inspectors found, August 2018
Rated Good; inspectors found safe, kind care, but the home needs to improve care plans and meaningful activities.
Inspectors visited without warning on 18 and 19 July 2018. They spoke with people, relatives, staff and health professionals. They also reviewed care plans, medicines records, staff files, rotas and quality checks.
The home was rated Good overall. It was rated Good for Safe, Effective, Caring and Well-led. Responsive was rated Requires Improvement because some care plans were out of date and some people did not always have meaningful activities.
The home had improved since the previous inspection in July 2017, when it was rated Requires Improvement and had three legal breaches. Inspectors found those breaches had been addressed. Some issues found during this inspection were being dealt with by the acting manager after the visit.
Kind and respectful care
Inspectors saw caring relationships. People’s privacy, dignity, choices and independence were respected.
“Throughout the inspection staff were observed to have caring relationships with people and demonstrated a kind and compassionate approach.” from the report
Safer staffing
Inspectors found enough staff to meet assessed needs. Recruitment checks had been completed before staff started work.
“At this inspection we found there were enough staff to meet people's needs.” from the report
Good leadership and feedback
People, relatives and staff spoke positively about the acting manager. The home used meetings, surveys and checks to identify improvements.
“This showed that staff respected and valued the acting manager and that the service was well-led at all levels” from the report
Medicines paperwork
needs fixingSome decision-to-administer forms for covert medicines had not been updated when prescriptions changed. Medicines returns were also not documented properly, although the acting manager took action after this was raised.
“However, not all 'decision to administer' forms were updated to match people's changing prescriptions and not all medicines were disposed of appropriately.” from the report
Out-of-date care plans
needs fixingSome care plans did not reflect changing needs and were difficult to follow. This meant staff might not have a clear, accurate picture of the support a person needed.
“This confirmed that care plans were not easy to follow and did not paint a clear picture of a person and their individual support needs.” from the report
Activities were not always meaningful
minorInspectors saw that some people were not engaged in meaningful activities and were dozing in chairs. The home said it had recruited an additional activities co-ordinator.
“However, during observations we noticed that on occasions people were not engaged in meaningful activities and were seen dozing in their chairs.” from the report
No registered manager during the visit
minorThe home did not have a registered manager when inspectors visited. The report later says the acting manager became registered after the inspection.
“At the time of this inspection the service did not have a registered manager in place.” from the report
- 01How do you make sure each person's care plan is updated when their needs change?
- 02How do staff learn about a person's risks and support needs if information in the care plan is unclear or inconsistent?
- 03Have all decision-to-administer forms for covert medicines been reviewed against current prescriptions?
- 04How are medicines now recorded and collected for disposal?
- 05How do you make sure people who cannot join group activities have regular meaningful one-to-one activities?
This was an unannounced inspection of the overall service, covering all five areas and both the home and the care provided. This explanation was written from the published report of 31 August 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, December 2017
Rated Requires Improvement; inspectors found kind and personalised care, but concerns about medicines, staffing, training and management systems.
Inspectors visited the home without notice on four days in July 2017. They spoke with people, relatives and staff, observed care, and checked care records, medicines records, staff files and quality checks.
They found caring and respectful staff, personalised care plans, suitable food and access to health professionals. People and relatives also said the home was caring, and people knew how to complain.
However, medicines were not always managed safely. There were concerns about staffing levels, staff training and supervision, risk records, activities and quality monitoring. The home breached three regulations.
The overall rating and all five question ratings were Requires Improvement. This means the home was not consistently meeting the required standards, although inspectors also found areas that were working well.
Kind and respectful care
People and relatives described staff positively. Inspectors also observed kind, respectful and personalised interactions.
“Observations showed staff interacting with people in a kind, respectful and personalised way.” from the report
Personalised care plans
Care plans included people's needs, preferences, medical conditions, religious beliefs and personal histories. They were reviewed and updated.
“Care plans were detailed, personalised and included information about people's individual needs as well as their preferences such as their preferred names and food.” from the report
Food and healthcare
People had suitable food and drinks, including meals adapted to dietary needs. They were supported to see doctors and other health professionals.
“People using the service had access to appropriate meals to ensure their nutrition and hydration needs were met.” from the report
Complaints handled
People and relatives knew how to complain. The complaints reviewed by inspectors had been dealt with under the home's procedure.
“All complaints received had been responded to and resolved in line with the providers' complaints procedure.” from the report
Medicines were not always safe
seriousInspectors found unsafe recording and administration of medicines. Guidance for covert medicines was unclear, some records were incomplete, and one person missed medicines because stock was unavailable.
“Medicines were not always managed and administered safely.” from the report
Staffing levels
seriousPeople, relatives and staff raised concerns about too few staff, particularly at night and at weekends. The home had nurse and care worker vacancies.
“We remain concerned people using the service may be at risk of not having adequate staff available to meet their needs.” from the report
Training and supervision
seriousNursing staff reported cancelled clinical training and concerns about supervision. Six staff files had no record of induction.
“We found six files checked had no record of staff induction.” from the report
Weak quality checks
seriousAudits did not reliably identify problems with medicines, training, supervision and records. Some action plans did not show when actions had been completed.
“Quality monitoring systems in place were not used effectively and did not identify the issues we identified during the inspection” from the report
Inconsistent activities
needs fixingActivities varied between units. Some people mainly watched television, and not everyone had an individual activity planner.
“This meant the service was not always responsive to people's preferences for meaningful activities.” from the report
- 01What has changed since the inspection to make medicines administration, covert medicines guidance and medicine stock checks safe?
- 02How many nurses and care workers are currently on duty on each unit, including at night and at weekends?
- 03How do you make sure all staff receive induction, ongoing clinical training and useful supervision?
- 04How are risks such as falls, feeding tubes and refusal of medicines recorded, reviewed and communicated to staff?
- 05What individual and group activities are now available, including at weekends, for someone with this person's needs and interests?
This was an unannounced comprehensive inspection of the overall service, covering all five areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 29 December 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 Park View
3 rated inspections over 2 years: the service has held its Good rating throughout.
- August 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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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