This inspection took place on 28 June 2017.

Parklands Care Home is registered to provide accommodation for persons who require nursing or personal care without nursing for up to 14 older people. There were 12 people living in the home on the day of our inspection. The home is situated on the outskirts of Preston close to local amenities and public transport links to the city centre. Accommodation comprises of communal lounge and dining areas as well as a conservatory. There are thirteen bedrooms one of which is shared between two people with privacy screens to use during personal care activities. All of the bedrooms have hand washing facilities and one benefited from ensuite facilities.

The service had registered manager in post. 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 last inspection on 20 April 2016 we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment, Regulation 11 Need for consent and Regulation 17 Good governance. During this inspection we found improvements had been made.

We saw the provider had made improvements in the recording, administration and management of medicines. To enable individual risks to be safely managed risk assessments had been completed. Relevant checks on the environment were taking place and staff had access to training, guidance and equipment to ensure infection control risks were minimised.

Staff were aware of the procedures to take when dealing with allegation of abuse. People who used the service, visitors and professionals raised no concerns about the safety of people living in the home.

There was evidence of appropriate numbers of staff available to support people’s individual needs. Recruitment procedures ensured people were safely recruited for the role in which they were employed.

Staff received the relevant training required to support people’s needs effectively in the home. People who used the service and professional told us they were confident in the knowledge and skills of the staff to meet people’s individual needs.

Since our last inspection the provider had introduced capacity assessments for people who lived in the home. Where DoLS applications were required these had been sent to the assessing authority. 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 supported this practice.

It was clear during our observations of the lunchtime period that people enjoyed the meals provided by the home and were offered choices of menus.

We observed a calm, relaxed homely atmosphere in the home. It was clear for the interaction between people who used the service, staff and visitors that they knew each other well and responded in a timely manner to people’s needs and wishes.

People told us they were happy with the care they received and staff treated people with dignity and respect. Where people required support with care this was done in th privacy of their own bedrooms or the bathroom.

We saw positive feedback about the care people received in the home. People told us they had no complaints about the service and there were policies in place to guide people on the process of complaints.

People were mixed about the activities provided by the home. There were photographs of activities taking place and equipment in the home for people to use, such as table top games. However some people we spoke with were mixed about the activities they took part in.

Care files had information

This inspection took place on 20 April 2016 and was unannounced.

The service was last inspected 10 October 2013. At that inspection we found the service was meeting the legal requirements in force at the time. We made some recommendations for the provider to consider, which included ensuring hand written medicine administration records were double signed to avoid transcription errors. We also recommended the provider ensure they obtained two references before staff were appointed to work at the home. We checked to see if these recommendations had been taken on board and found the home had followed them up.

Parklands Care Home provides accommodation for up to fourteen people, who require help with personal care needs. The home is situated close to Preston City Centre and is within easy reach of public transport, and local amenities. Accommodation within the home is situated on two floors. There are ten single rooms and two shared bedrooms. Three rooms have en-suite facilities.

There is a passenger lift and stair case providing access to the upper floors. Comfortable communal areas, such as lounges and a dining room are available. A limited number of car parking spaces are available to the back of the building on a private forecourt, but on road parking is also permitted however this is limited.

The registered manager was present throughout our inspection. The provider also joined the inspection at various points in the day. 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 and associated regulations about how the service is run.

At the time of this inspection there were fourteen people who lived at Parklands Care Home. People told us that they felt safe.

We looked at how the service protected people against bullying, harassment, avoidable harm and abuse. We found that staff had received training in safeguarding adults and demonstrated a good understanding about what abuse meant.

The provider had recorded accidents and incidents and documented the support people were getting after experiencing falls. We found evidence staff had sought advice from health professionals.

We found people’s medication was not being managed safely. People did not have care plans for ‘as and when medication (PRN)’. People’s homely remedies had not been safely managed and the self-medication policy was not effectively applied to ensure those who cannot manage their own medication are supported. Staff had received appropriate medication training.

There was a building fire risk assessment on the premises. However it had not been updated in line with the fire policy and fire regulations.

People did not have personal emergency evacuation plans (PEEPS) which were meant to enable safe evacuation in case of emergency.

We found infection control measures were not effectively implemented.

Staff were suitably recruited and there were enough staff to ensure that people's needs were safely met. There was scope within the staffing levels to keep checks on people's welfare and, where necessary, to provide extra care and support.

Some staff showed awareness of the Mental Capacity Act, 2005 and how to support people who lacked capacity to make particular decisions. However we found the knowledge was not sufficiently turned into practice and was not sufficiently embedded when planning for care and supporting people on a daily basis.

We found that people’s health care needs were effectively assessed on admission to the service to ensure the home was able to meet their assessed needs.

Consent was not consistently sought from people. However we found evidence people were involved in their care. The home did not consistently involve people in decisions made around the care they received. Care plans did not evidence people’s involve

People were admitted to the home following an assessment of their needs and an agreement that their needs could be met.

Every person we spoke with told us they were very happy with the care and support they received from staff.

“Its home from home here. We all get on very well. The staff are lovely. They make you feel special and that they really care about you”. “When I came here I couldn’t walk but now I can. The staff have been wonderful. I’m happy with my life”.

People said staff were attentive to their needs. We observed staff being polite, helpful and showing a caring nature to people. Staff knew how to care for people at risk of falling, developing pressure ulcers or who may not eat enough. People had their medicines that were prescribed when they needed it.

Activities were good and age appropriate. People told us they were satisfied with the catering arrangements. People commented on the quality of food. They said “We’re well fed”. “It’s all homemade. Its good and I can have what I want”. Another person said, “They always make sure you have what you like. I like a slice of toast at supper. There are other things you can have, but that’s my favourite”.

Staff were trained properly and supervised in their work.

People were consulted in matters relating to their care and welfare. They said, “Nothing happens without our approval, we’re always asked what we think, food, outings, comfort, you name it they ask”.

During our visit we talked to many of the service users who were all complimentary about the home and the care they received. Here is a selection of the comments we received:

“We are well loved here.”

“It is a lovely home.”

“We are well cared for the staff are so lovely and caring.”

“I am able to make decisions about what I want.”

“If I don’t like something I just ask and I get something else.”

“The food is lovely.”

“Staff have been trained to look after me and they do it very well.”

People told us they could make their own decisions regarding their care and support. They said staff attended to all their personal care needs as they required. One person commented, “We have a very good time with the staff, we get well looked after”. Another person told us. “They never leave you. If they take me to the toilet, they will stay until I’m ready giving me the privacy I want”.

Other people told us “Well satisfied and no grumbles. I have a nice room, good bed, good food, excellent service. Whatever I want they would get for me”. And, “You can ask for anything. If you’re not well they get the doctor, a dentist also calls and a chiropodist. I like a good sleep and they make sure I get it”.

People told us they did not have to conform to any rigid routines. They could please themselves how they lived their lives. They felt safe in the home and thought their accommodation was very good. They said the home “feels very much like home rather than a residential care home”. And, “It’s lovely here”. “I’m nice and comfy and cosy. It’s lovely and warm”.

We found people were cared for by staff that were recruited properly and trained well. People living in the home described staff as being, “Like family, lovely”. “Wonderful”. “Very respectful”. And, “A very friendly lot”. We were told staff came when summoned. One person told us, “I feel safe because they come straight away when I ring for them”.