This inspection took place on the 20, 21 and 22 November 2018, with the first day being unannounced. This was the first inspection of Gorton Parks Care Home since it had been bought by Advinia Care Homes Limited in March 2018. The staff teams for each house remained the same. A new registered manager joined the home in July 2018. One clinical services manager (CSM) remained the same, with a second CSM being appointed in November 2018. Changes had been made at the provider’s area manager level and above. The home, under its previous ownership (Bupa), was inspected in July 2017. References throughout this report to 'the last inspection' concern this inspection.

Gorton Parks is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Gorton Parks is registered to accommodate up to 148 people across five separate houses. Three houses specialise in either nursing or residential care (Sunnybrow, Abbey Hey and Melland). Delamere and part of Debdale are ‘intermediate’ care beds which provide re-ablement services for people discharged from hospital. The care staff in these houses are employed by Advinia, with the NHS providing the nurses, physiotherapists and occupational therapists. The other half of Debdale is a nursing unit run by Advinia.

Each house has a lounge, dining area, a conservatory, and a kitchenette. All bedrooms are single with no ensuite facilities. Accessible toilets and bathrooms are located near to bedrooms and living rooms.

There was a registered manager at Gorton Parks. 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.

At our last inspection in July 2017 we identified three breaches of Regulations because medicines were not safely managed, activities were not organised to stimulate people, there were insufficient staff to meet people’s needs at meal times and quality assurance audits had not been sufficiently robust.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, caring, responsive and well led to at least good. At this inspection we found some improvements had been made.

We found improvements had been made and medicines were now managed safely and four activity co-coordinators had been recruited and people were positive about the activities now being organised on each household.

However there continued to be a breach in regulations as staffing levels on Sunnybrow household, especially during mealtimes due to the number of people who needed support to eat their food, were insufficient. Feedback about staffing levels for the other units was positive.

We also identified a breach in regulations because two care plans on Sunnybrow were not reflective of people’s current needs. The care plans we viewed on the other units reflected people’s identified needs and were reviewed each month. Risks had been identified and steps taken to reduce the likelihood of the identified risk occurring. Where people might have behaviour that challenges, care plans gave details of potential triggers and behaviours.

You can see what action we told the provider to take at the back of the full version of the report.

Improvements had been made to the quality assurance system, although these were still bedding in at the time of our inspection. Actions identified from the audits were completed for the specific care plan or medicines plan reviewed but were not applied across all plans on the household. The home planned to increase the number of care plans