This unannounced inspection took place on 5 and 11 January 2017. The inspection activity on 11 January involved speaking to relatives and healthcare professionals by telephone. At the previous inspection in October 2015 we found the provider was not meeting regulations 12,15 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These shortfalls related to the safe management of medicines, infection control procedures, having safe, maintained and suitable premises and quality assurance processes.

At this inspection we found that the provider had made improvements and the service was now meeting the regulations.

Parkvale provides residential care for up to seven gentlemen with learning disabilities and/or mental health issues. It is situated in a residential area within easy access of local amenities. At the time of our inspection there were five people living at the service, with a further two people due to move in within a few weeks.

The service had a 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.

People told us they felt safe living at the home. Relatives told us they were confident their family member lived in a safe environment.

People lived in a clean and homely environment, with their bedrooms tailored to meet their own likes and dislikes.

People received their medicines appropriately. Staff at the service were trained to administer medicines to people safely and securely.

Staff had a good understanding of safeguarding procedures. They also knew how to report any concerns they had and confirmed they would do this if they suspected any harm or abuse had occurred.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. In England, the local authority authorises applications to deprive people of their liberty. We found the provider was complying with their legal requirements in respect of this act.

Relatives and staff all told us they felt there were enough staff to meet people’s needs. The registered manager monitored staffing levels to ensure enough trained staff were available at all times. The provider had systems in place for the safe recruitment of staff, including Disclosure and Barring Service (DBS) checks. The registered manager had a programme of staff training, supervision and appraisal in place and monitored this to ensure all staff were kept up to date with any training needs and support.

Maintenance work was completed as required and the provider had emergency procedures in place for staff to follow.

People told us they enjoyed the food prepared at the service. We found people received a range of nutritious meals and refreshments throughout the day and were able to make their own if they were able of doing so.

People were respected and treated with dignity and kindness. People and their relatives we spoke with highlighted the quality of care provided by staff at the home. One person told us, “Staff are canny [nice], they look after me.”

People were treated as individuals and their care needs were monitored so any changes were identified and procedures put in place to address that change. People’s records were regularly reviewed and discussed with the person, and their relatives where possible. Best interest decisions had been made where necessary.

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People told us they were happy with the care and support they received. One person said, "I am happy with everything." Another person said, "I am very happy with everything and I like all the staff."

People told us their consent was gained prior to care being delivered and we found that staff acted in accordance with their wishes.

We found that people's care and support needs were appropriately assessed and their care was planned. They received care safely, and to an appropriate standard.

People were cared for in a clean and hygienic environment and we found the provider had appropriate measures in place to monitor and manage infection control.

There were enough suitably skilled and qualified staff on duty to meet people's needs safely and appropriately.

We saw the provider had a complaints policy and procedure in place, which people had access to.

We carried out this inspection to check whether previous shortfalls in staff attitudes and behaviours, and their lack of respect for people, had been addressed. These issues had been identified during our last inspection at the service on 3 September 2012.

At this inspection we found that people were treated with dignity and respect. People told us previous problems with staff attitudes and behaviours had been resolved and as a result there had been a positive impact on their lifestyles. One person said, "We have new staff now, things are a lot, lot better." Another person said, "I cannot thank you enough. All of the problems that we had have now been resolved. The house is a lot happier environment. It makes us happier. We just ask if we want to go out now and there are no 'ifs' or 'buts', they (staff) take us out."

We found the provider had taken action since our last inspection to ensure that people were treated with dignity and respect and improvements had been made.

People told us that generally they were happy living at Parkvale. One person said there had been a recent change of management and they were confident improvements to the service would be made.

This unannounced inspection took place on 20 October 2015 followed by an announced visit on the 21 October 2015. The previous inspection which was undertaken in October 2014 found no breaches of the regulations in force at the time.

Parkvale provides residential care for up to seven people with learning disabilities and/or mental health issues. At the time of our inspection there were seven people living at the service.

The service had a 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.

We found some shortfalls in the maintenance of the property mainly in connection with the decoration of the service.

Staff had not protected people from harm by ensuring robust infection control procedures were followed. We found people were not supported to keep their bedrooms clean.

Staff administered people’s medicines proficiently. They had received suitable training to ensure they were able to do this safely. However, we found some shortfalls in the safe management of medicines.

We spoke to all of the people living at the service and all that were asked, said they felt safe.

Staff had an awareness of safeguarding procedures and knew what to do if they suspected any form of abuse occurring. One staff member said, “I have never had to report anything, but would if I had to.”

Accidents and incidents that occurred were recorded and risk assessments completed to minimise the levels of risk to people living at the service. The provider had emergency procedures in place for staff to follow should they find a situation where they needed additional support and information or advice.

Checks had been completed to ensure that the building and the equipment within it was safe to use, including electrical and fire safety equipment.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. In England, the local authority authorises applications to deprive people of their liberty. We found the registered persons were complying with their legal requirements.

People told us, and their care records confirmed, that they had access to healthcare professionals should the need arise. People had visited GP’s, physiotherapists and dentists for example. One person had been referred to a consultant for onward treatment which meant their condition was monitored and appropriately managed.

The service required staff to be available to support people 24 hours every day. We asked people if they thought there was enough staff. They told us they thought there was. One relative said, “They [staff] do what is needed, I think there is enough.” The provider had a system in place to ensure that suitably skilled and appropriate staff were recruited into the service.

Supervision was completed regularly and staff received annual appraisals from their line manager.

The needs of people had been thoroughly assessed and staff regularly completed reviews with them to ensure their care plans remained relevant. People told us they were fully involved in the care planning process. People told us they all had a key worker who helped them with any issues and were there to support them and give some consistency in their lives.

People told us the food was good and they enjoyed what they had to eat and drink. They said they had a wide variety of food, including some food from takeaways if they so wished. We observed meals being prepared in the kitchen, and found it was done with reference to food hygiene procedures. We observed people helping in the preparation of some of the meals.

People were respected and treated with dignity. Staff were considerate and encouraging when providing care and support to people. They supported people to express their views and listened and communicated well with people. It was apparent people got on well with their care workers.

Care plans were in place to guide staff as to how care should be provided and how best to support individuals in their care.

People were independent in the variety of activities they chose to be involved in on a day to day basis. One person chose to fish, while another chose to be involved with football.

People understood how to make a complaint or raise any concerns about their care. The registered manager had checked to make sure people understood how to do this. Documents about making a complaint were available to people who used the service.

People were asked their views on the service and about their care, although this information was not always analysed by the provider, as was the case with recent surveys completed.

The registered manager completed a number of audits and checks but there was little evidence of them being monitored by the provider and we found no appropriate infection control audit being used. Records were limited of the quality assurance visits carried out by the provider’s representative.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to premises, medicines and good governance. You can see what action we told the provider to take at the back of the full version of this report.