This inspection took place on 07 and 08 August 2018 and was unannounced. This was the first inspection of this home since it had been acquired by the provider, late in 2017.

Mersey Parks Care Home 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.

The home is registered to provide accommodation and care including nursing, for 150 people. The site comprises four accommodation units and an administration block. Each of the units accommodates about 30 people. Two units specialise in residential care for people with dementia, a third provides general nursing care and the fourth provides general residential care. At the time of our inspection, there were 100 people living in the home permanently and two people were there for periods of respite care. The home is purpose built and is situated near good public transport links and is surrounded by a garden area.

The service requires a registered manager. 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 the time of this inspection, there was a registered manager who had been with the service for some time, both for the previous provider and the current provider.

We inspected medication storage and administration procedures in the home. These were varied, as some of the documentation was incomplete and storage was not consistently good. We found evidence that some medicines administered did not have the correct or consistent documentation to show how decisions had been made about how to administer them.

There were approximately 140 staff, comprising registered nurses, carers, maintenance, domestic, kitchen and laundry staff and administrative staff. Many of the staff had been with the service for over 10 years. There were unit managers for each unit and a clinical services support manager. However, staff and some people and visitors felt there were not enough staff on duty. Staff and visitors told us there were insufficient staff. We have recommended that the service reviews staffing numbers.

Many staff had been trained by the previous provider, but the training schedule for this year was only a third completed. We have recommended that the service regularly reviews its training schedule.

The service was in the middle of moving all its paperwork and its policies and procedures over to those of the new provider. The documentation was in either the old providers or the new providers format, but it was not consistent throughout the home and many of the old care files were disorganised. We felt that insufficient resources were being used to enable care plan reviews and updates to happen. The registered manager told us the provider would address this immediately. We saw that risk assessments had been completed which had identified risks to people’s safety and well-being and these were being updated. We have made a recommendation that this process be speeded up.

The registered nurses who were employed in the home had all had their PIN number checked each month to ensure it was current. A PIN number was issued by the nursing and midwifery regulator, the Nursing and Midwifery Council, when registered staff were considered to have the skills, knowledge, good health and good character to do their job safely and effectively; this was also known as being, ‘fit to practice’.

The registered manager had a good knowledge of the Mental Capacity Act and its associated Deprivation of Liberties Safeguards, but some staff told us they had not received recent training in this. Staff training showed generally poor take up, but