A comprehensive inspection of Park Avenue Care Home, took place on 2 and 4 January 2019. The inspection was unannounced on day one and announced on day two as we needed to make sure the registered manager was available. This was the first inspection of the home since the new provider registered with the Care Quality Commission (CQC).

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

Park Avenue Care Home is in the Oakwood area of Leeds. It provides care for up to 43 older people and people living with dementia. It is close to local amenities and is accessible by public transport.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the CQC 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.

Risks to people were not identified and managed safely and some areas of medicines were not well managed. Staff were not always given the opportunity to attend regular supervision and had not receive an annual appraisal in 2018.

People’s care plans did not contain consistent or sufficient information and were not always person-centred. Quality assurance systems needed to be improved to ensure people received a consistent quality service. Records showed trend analysis was completed on accidents and incidents, but there was no check to established if the category of accident or incident had been correctly recorded.

People told us they felt safe in the home and staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. Staffing levels were sufficient and there were appropriate numbers of staff deployed in the home. Recruitment of staff was mostly well managed and relevant checks had been carried out to make sure suitable staff worked with people who used the service. Staff received an induction and ongoing training required to meet people’s needs.

Building maintenance and fire safety was appropriately managed as the necessary checks had been completed. The home was clean and tidy and there were effective systems in place to reduce the risk and spread of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did support this practice. We found the service was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

We observed a positive mealtime experience and saw people were well supported. People were happy with the food they received. People could access a range of healthcare professionals.

Comments from people and relatives confirmed staff provided good care. Staff had a good rapport with people and we observed people were well cared for. People’s privacy and dignity was respected and people could individualise their bedrooms. People were supported to remain as independent as possible and advocacy services were available if required. Staff had a good understanding of what care and support people might need as they were approaching the end of their life.

We observed some activities taking place on both days of our inspection. The registered manager told us a new activity coordinator was due to start shortly and this would further improve the range of activities.

Relatives told us they knew how to complain and were confident the registered manager would address their concerns. Complaints were appropriately dealt with and responded to in a timely way by the provider. People who used the service, relatives and staff we