Parkville Care Centre

At the lasted rated inspection this key question was rated as good. At this inspection the rating has remained good. This meant overall people were safe and protected from avoidable harm. In the last year there had been an instability in management, and this had led to an increase in staff turnover and a deterioration in practices such as medicine management. Medicine management had not always been effective but action was being taken to resolve these matters. The quality improvement manager had completed a full review of medicine management, checked staff competencies and ensured, when needed, staff received additional training. External professionals reported practices were improving in the service. We found staff understood their role in ensuring medicine was safely administered. Relatives felt people were safe, but some discussed how they felt staff had not always accurately recorded information about people’s health. A new electronic record keeping system had been introduced and the quality improvement manager had been regularly reviewing the entries to make sure they reflected the care and support given. Work was being undertaken to complete a full refurbishment of the home and new maintenance staff had been employed who understood the requirements of their role. They were ensuring all the necessary checks were completed. Staff understood safeguarding procedures and referrals were made as needed. The management team reviewed these and any incidents to determine if there were any themes, lessons that could be learnt and checked that appropriate action was taken. Risks were assessed and action taken to mitigate any risks. People were supported to do the things that were important to them and manage any associated risks. Staff followed appropriate infection control measures. Recruitment practices were meeting requirements. There were enough staff to deliver the care and the provider ensured any vacancies were quickly filled.

At the lasted rated inspection this key question was rated as good. At this inspection the rating has remained good. This meant on the whole people’s outcomes were consistently good, and people’s feedback confirmed this. People’s needs were assessed before they came to use the service. Only people who the team were confident they could meet their needs were accepted to be supported by the service. Assessments were used as the basis for the care records. The care records clearly detailed people’s needs. The registered manager and staff worked to maximise the effectiveness of people’s care and treatment by consistently reviewing their health, care, wellbeing and communication needs with them. The support offered was delivered in line with legislation and current evidence-based good practice and standards. Staff had received mandatory and condition specific training. Staff supervision sessions were in the process of being completed in line with the provider's policy. Staff had received training around the Mental Capacity Act 2005 and associated code of practice. Staff understood the requirements of the MCA and appropriately applied for deprivation of liberty safeguards. They completed capacity assessments and held ‘Best Interests’ meetings with multidisciplinary teams, as needed. Staff worked with local healthcare professionals and sought advice when required. Visiting professionals told us staff were skilled, competent and they supported people well. Staff work as a team to ensure people’s support needs were met. We observed people had been enabled to maintain their skills and independence. Staff had followed best practice around dementia care so stepped in to meet people’s needs, which had led to people retaining their communication skills and social façade. People were really engaged in the life with the community.

At the lasted rated inspection this key question was rated as good. At this inspection the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care. People appeared very at ease with staff. People told us staff treated them with dignity, kindness and they felt staff really cared about them. Staff were aware of people’s needs, views and wishes and these were responded to appropriately and in a timely manner. They sought people’s views about how to support them and, when appropriate, relatives were included in discussions about the support being offered. Processes were in place to take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. People reported staff promoted their rights, choices and independence. Since coming into post the management team had been closely monitoring the care being delivered to make sure people were appropriately supported. They also ensured staff well-being was maintained and they had adequate support to deliver the service. Staff were extremely positive about the management team and how well supported they felt. They described how their work was routinely praised and recognised by the new management team. They discussed the positive differences the management team had made as well as the previous difficulties they had faced. All felt confident they could deliver the service in line with expected best practices and their ideas were valued.

At the lasted rated inspection this key question was rated as requires improvement. At this inspection the rating has improved to good. This meant people’s needs were met through good organisation and delivery. The management team ensured everyone could access the care, support and treatment they need when they needed it. Care planning was person-centred. The registered manager and staff ensured everyone could access the care, support and treatment they need when they need it. People were at the centre of their care and support. Information was available in a variety of formats and in a way they could understand. Whilst we were there the senior management team had strengthened the way staff engaged with people’s whose first language was not English. They worked with the people’s relatives to find out individual’s views but had asked them and local communities to work with staff to learn common phrases. Also, they had asked local communities if they would come and spend time with people chatting in their first language. The registered manager understood the diverse health and care needs of people and their local communities. They aimed to provide care, which is joined-up, flexible and supports choice and continuity. The staff strongly advocated keeping people at the centre of their care and treatment choices. They decided, in partnership with them, how to respond to any relevant changes in their needs. People felt the registered manager and staff listened to them and acted on any concerns. People knew how to raise a compliant and found action was taken when concerns were expressed. The systems in place made it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. The provider had systems in place to support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

At the lasted rated inspection this key question was rated as good. At this inspection the rating has remained good. This meant the service was managed by leaders who created a culture aimed at promoting high-quality, person-centred care. The provider had a clear position around developing services which were person-centred and tailored to individual's needs. They aimed to have a culture in which people feel they could speak up, air their views and these would be heard. The director discussed recent difficulties within the service and the action being taken to work with staff to ensure an open culture was always operated and staff felt empowered to share their ideas. Staff discussed how they now felt empowered to speak up and felt their views were taken on board. When we inspected the registered manager had been in post 3 weeks and staff reported they were closely working with them to make sure the standard of care provided was in line with expected practices. The provider had developed a clear governance system and constantly looked at how to make improvements. They had a quality team and people team who worked with locations to ensure staff could raise matters and areas for improvement could be readily identified and acted upon. The management team encouraged continuous learning, innovation and improvement across the organisation. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Staff were passionate about providing good care outcomes and took ownership for their practice. Staff understood their duty to collaborate and work in partnership.