Crownwise Limited - Parkview

Parkview accommodates up to seventeen people in one large house over three floors, in the London Borough of Lambeth. At the time of the inspection there were 15 people using the service.

The service had a registered manager in place. 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 service was inspected previously on 15 and 18 November 2016 and was given an overall rating of 'requires improvement'. This was because the service failed to provide staff with adequate guidance on how to manage identified risks. The service also failed to ensure staff received adequate support through regular supervisions, annual appraisals and necessary training to enable them to undertake their duties effectively. The service did not have robust systems and processes in place to identify pitfalls in the quality and safety of the service delivery.

At this comprehensive inspection we found the provider had made improvements to the service in relation to risk assessment guidance, staff training, support and auditing processes.

We made a recommendation in relation to the management structure at the service.

Systems and processes in place identified risks and gave staff clear guidance on how to mitigate those risks. Risks were reviewed regularly to identify trends, patterns and positive behavioural plans were then implemented.

People were protected against the risk of harm and abuse. Staff were aware of how to identify, report and escalate suspected abuse and were aware of the provider's whistleblowing policy.

Staffing levels were adequate in meeting people's needs and keeping them safe. Staff received support and guidance through regular one to one supervisions and annual appraisals where they reflected on their working practices. Staff received regularly training to increase their skills and knowledge.

People's medicines were managed safely. Records indicated no errors or omissions. Medicines were stored in line with good practice and stocks and balances showed people received their medicines as prescribed.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We checked whether the service were supporting people in line with the MCA and found the service was working within legislation.

People's consent to care and treatment was sought prior to care being delivered. People were supported and encouraged to make decisions relating to their care, and have their decisions respected.

People's health and wellbeing was monitored and assessed for any signs of deterioration. People had access to a wide range of healthcare professionals as and when required.

People received compassionate and caring support from staff that knew them well and treated them with dignity and respect. People's right to privacy was adhered to and people had their independence monitored and encouraged.

People continued to receive personalised care, which was responsive to their needs. Care plan reviews were held regularly and where possible people were encouraged to participate in their development.

People were encouraged to raise any concerns and complaints, where possible these were dealt with informally. Official complaints were clearly documented with action taken to reach a positive outcome for all involved.

The service provided regular activities and where possible people were encouraged to access the community and had their social needs met.

Regular auditing of the service enabled the provider to take action to address identified issues in a timely manner. People's views of the service were sought through regular meetings and quality assurance questionnaires.

The registered manager encouraged partnership working with other healthcare professionals to drive improvements within the service.

The five questions we ask about services and what we found