CQC report explained · a nursing home
What the CQC found at Parkside Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Rated Requires Improvement, with well-led rated Inadequate; inspectors found unsafe infection control, poor oversight and inconsistent care in some areas.
This was an unannounced follow-up inspection. Inspectors spoke with people, relatives and staff, observed care, and reviewed care, medicines, staffing and management records. They also checked infection prevention and control.
The home was not consistently safe, effective, caring or responsive. Inspectors found poor hygiene in some areas, damaged safety equipment, gaps in risk information, an environment that did not support people living with dementia, and inconsistent activities and engagement.
Management oversight was rated Inadequate. Audits had not identified several problems found by inspectors. The home had no registered manager in post and had continued breaches of regulations. This was the third consecutive inspection with an overall rating of Requires Improvement.
There had been improvements since the previous inspection. Medicines were managed safely, staff training and supervision had improved, and consent arrangements were now in line with the law. However, the home remained in breach of regulations about person-centred care, safe care, premises and equipment, and good governance.
Medicines
Medicines were managed safely. Records, storage, stock checks and staff competency checks were in place.
“Medicines were managed consistently and safely in line with national guidance.” from the report
Staff training
Staff had relevant training, supervision and induction. The report says this had improved since the previous inspection.
“There was full compliance with the provider's training.” from the report
Consent and choice
Staff supported people to make choices and used least restrictive options when people lacked capacity.
“People were supported to have maximum choice and control of their lives” from the report
Respect and dignity
Inspectors saw staff treating people respectfully at times. Staff protected privacy during personal care and encouraged independence.
“People were treated with respect by staff.” from the report
Family communication
Relatives said the manager was approachable and that they were informed about important incidents and health changes.
“Family members confirmed that they were informed of all incidents and any health concerns concerning their relative.” from the report
Infection control
seriousSome cushions, chairs and crash mats had torn fabric, while other areas and equipment were dirty or poorly stored. These problems had not been found by the home's audits.
“The provider had failed to follow good infection control practices.” from the report
Unsafe equipment and incomplete risk information
seriousOne person's mattress did not fit the bed, leaving a gap that could cause injury. Care records did not always set out the extra support needed for conditions such as diabetes, wounds or Parkinson's disease.
“The provider had failed to ensure that additional care needs associated with specific healthcare conditions were consistently documented and equipment provided was safe for such use.” from the report
Poor environment
seriousThe home did not provide enough signs, colour contrast or meaningful areas to help people living with dementia. Inspectors also found cracks, peeling paint, damaged fittings and heavily stained carpets.
“Many areas of the premises were in a poor state of repair.” from the report
Activities and engagement
seriousPeople cared for in their rooms did not always receive activities or social contact that matched their interests. Activity records had gaps and did not always explain what had happened or its effect.
“The provider failed to consistently support the needs of people cared for in their rooms.” from the report
Management oversight
seriousAudits did not identify several problems found during the inspection. The home had a history of continuing regulatory breaches and had not sustained improvements over time.
“The systems and processes in place were not effective in monitoring, assessing and improving the quality and safety of the service.” from the report
Communication
minorSome relatives said language difficulties made it harder for their family members to explain what they wanted. CQC recommended that the provider seek advice to improve communication.
“The language barrier is a real issue. Their lack of understanding is obvious.” from the report
- 01What changes have you made to replace or repair torn cushions, chairs, crash mats and other equipment, and how do you check they remain safe?
- 02How do you now check that infection control problems, dirty areas and poor storage are found and fixed promptly?
- 03What activities are provided for people who are cared for in their rooms, and how do you record their participation and response?
- 04What changes have been made to help people living with dementia find their rooms and move around the home independently?
- 05Who is currently responsible for management, and what progress has been made with registering the manager and meeting the conditions imposed by CQC?
This was an unannounced comprehensive follow-up inspection covering all five key questions and infection prevention and control, after breaches found at the previous inspection. This explanation was written from the published report of 17 March 2023 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, April 2022
Requires Improvement; inspectors found unsafe medicines practice, weak records and inconsistent consent, care and management.
This was an unannounced inspection on 1 March 2022. Inspectors spoke with people, relatives and staff, reviewed care and medicines records, and checked training and management information. The inspection was prompted partly by concerns about infection control, medicines and nursing care.
The home was not always safe or effective. Medicines were not always handled safely, infection risks were found, and staff training and supervision were not strong enough. People's consent was not always recorded properly. Care plans were sometimes incomplete or out of date, and people cared for in their rooms did not always receive meaningful activities.
Some people and relatives said they felt safe and described staff as kind. Food was praised, and people were supported to access healthcare. However, all five areas were rated Requires Improvement. The home had also received this rating at the previous inspection in 2019, and inspectors said there had not been enough improvement.
People felt safe
People and relatives told inspectors they felt safe from abuse. Staff understood safeguarding procedures and knew how to report concerns.
“People and their relatives told us they felt safe from abuse.” from the report
Food and healthcare
People were offered drinks and snacks, and their nutritional needs were recorded. Records showed regular access to healthcare professionals.
“One person told us that they enjoyed the food and said it was good quality.” from the report
Kind interactions
Although care was not consistently respectful, inspectors also saw staff comforting people and supporting them gently. People and relatives described staff as kind.
“We observed how one care worker gently encouraged and physically supported a person to move from their wheelchair to a chair.” from the report
Recruitment checks
The home completed required safety checks before staff started work. Nurse registration checks were also carried out regularly.
“The provider had systems in place to ensure safe recruitment of staff.” from the report
Medicines were not always safe
seriousA nurse left medicine with people without checking it was taken, and medicines were left on a trolley in a public area. Nurse competence had not been checked and records for some medicines were incomplete.
“Medicines were not always safely managed.” from the report
Consent was not reliably recorded
seriousThere was not always a decision-specific capacity assessment or evidence that people had agreed to care and treatment. Staff understanding of the Mental Capacity Act was inconsistent.
“The provider failed to always obtain people's consent before any care or treatment was provided.” from the report
Care plans were incomplete
needs fixingSome plans conflicted with other records or did not reflect current needs. Guidance was sometimes missing, including how people could call for help or how often they needed repositioning.
“Care plans were not always person-centred and did not always evidence whether people were engaged in planning their own care.” from the report
Dignity was not consistent
needs fixingInspectors heard disrespectful language and saw staff enter bedrooms without knocking. Some people were not given enough support to make informed meal choices.
“People were not always treated with dignity and respect and there were times when undignified language was used.” from the report
Activities and records were limited
needs fixingPeople cared for in their rooms were at risk of social isolation. Night staff did not always complete food, fluid or repositioning records, and weekend activities were not consistently provided.
“We found that people cared for in their rooms were at risk of being socially isolated due to the lack of provision of social activities for them.” from the report
Weak management oversight
seriousThe home's checks did not identify important problems with medicines, care plans, records and infection control. There was no registered manager in post at the inspection.
“The provider had poor oversight of the service, did not have a consistent approach to quality monitoring and service improvement and leadership was not always robust.” from the report
- 01What checks are now in place to make sure nurses and any agency staff administer and record medicines safely?
- 02How do you record decision-specific capacity assessments and people's consent to care and treatment?
- 03How are care plans checked and updated when a person's needs change, including risks such as choking, pressure ulcers and calling for help?
- 04What meaningful activities are now available for people cared for in their rooms, including at weekends?
- 05Who is currently responsible for management oversight, and what action has been taken in response to the warning notices?
This was an unannounced five key question inspection prompted partly by concerns about infection control, medicines and nursing care; all five ratings were assessed. This explanation was written from the published report of 30 April 2022 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 Parkside Nursing Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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