We undertook this unannounced inspection on 29 May 2018. Parkview House is a care home which is registered to provide personal care and accommodation for a maximum of 45

older people with dementia. The home is on two floors and divided into 5 units or “clusters”.

At this inspection there were 43 people living in the 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.

At our last inspection on 15 and 17 July 2015 the service was found to be compliant with regulations and was rated ‘Good’.

The home had a registered manager. Like registered providers, registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People told us they were safe living at the service and staff were kind. Health and social care professionals, relatives and people living at the service told us the staff were skilled and knowledgeable and able to provide suitable care.

We were concerned that staffing levels at night were insufficient to meet people’s needs, but the provider increased staffing levels at night the day after the inspection.

Risk assessments were in place to guide staff in safely caring for people, and care plans were up to date and covered a wide range of needs. Staff understood how to safeguard people from abuse and the service had appropriate procedures and processes in place.

Recruitment of staff was safely managed, and staff received regular supervision and training to support them in their role.

Medicines were safely stored and managed.

People told us they were happy with the food.

There were a range of activities at the service to meet people’s needs.

The service had appropriate documentation in place in relation to consent and compliance with the Mental Capacity Act 2005. 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.

A range of quality audits took place and the management of the service was praised by health and social care professionals, relatives and people living at the service.

We have made a recommendation in relation to staffing levels.

Parkview House provides care and support specifically for people with dementia. There are five separate units which accommodate up to nine people with dementia. We visited and spoke with people in all five units during the inspection

People were positive about the service and the staff who supported them. Throughout the inspection we observed staff involving people in decisions about their care and respecting their preferences. One person with dementia told us “They listen to you, that’s the main thing.”

The care and treatment plan for people with dementia was based on their initial assessment of needs and involved a number of healthcare professionals including doctors, nurses, occupational therapists and physiotherapists.

People with dementia and their relatives told us they were satisfied with the way the home met their health and social care needs. Records we saw indicated that people had good access to dentists, opticians and chiropodists on a regular basis. We saw that people were able to access social work support as well as attend day centres and access advocacy services.

Staff told us that there was very good communication between themselves and that they worked “as a team.” Staff told us that the care of people with dementia was discussed at each shift handover to ensure the continuity of support for people.

The service had a number of quality assurance initiatives to ensure that the quality of care provision was monitored and included the views of people with dementia and their relatives.

We undertook this unannounced inspection on 15 & 17 July 2015. Parkview House is a care home which is registered to provide personal care and accommodation for a maximum of 45 older people with dementia. The home is on two floors and divided into 5 units or “clusters”. At this inspection there were 42 people living in the home.

At our last inspection on 17 December 2013 the service was found to be meeting the regulations we looked at.

The home did not have a registered manager. The new manager had applied for registration with the Care Quality Commission (CQC) to manage the service. However, the application was withdrawn and the new manager was in the process of transferring to another service. The regional manager stated that a new manager would be recruited soon. Like registered providers, registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People and their relatives informed us that they were satisfied with the care and services provided. They said that people were treated with respect and people were safe in the home. Some people had dementia and did not provide us with feedback. However, we observed that they were appropriately dressed and appeared well cared for.

People’s needs were carefully assessed. Staff prepared appropriate and detailed care plans with the involvement of people and their representatives. Their healthcare needs were closely monitored and attended to. Staff were caring and knowledgeable regarding the individual care needs and preferences of people. The home had arrangements for encouraging people to express their views and experiences regarding the care and management of the home. People’s preferences were recorded and arrangements were in place to ensure that these were responded to. The home had an activities programme but effort was needed to provide a more varied range of activities so people could access adequate social and therapeutic stimulation.

There were suitable arrangements for the provision of food to ensure that people’s dietary needs were met. People were satisfied with the meals provided. The arrangements for the recording, storage, administration and disposal of medicines were satisfactory.

Staff had been carefully recruited and provided with training to enable them to care effectively for people. Staff had the necessary support and supervision from their managers. They knew how to recognise and report any concerns or allegations of abuse. There were enough staff to meet people's needs although regular staffing reviews were needed to ensure that any occasional staffing problems were dealt with.

The home had comprehensive arrangements for quality assurance. Regular audits and checks had been carried out by senior staff and the regional manager. These reflected the CQC standards expected of care services. The home had achieved the Beacon Award for Gold Standards Framework. This is a higher level award in recognition of the high standard achieved in providing good end of life care.

We found the premises were clean and tidy. The home had an infection control policy and measures were in place for infection control. There was a record of essential inspections and maintenance carried out. Risk assessments had been carried out and these contained guidance for staff on protecting people.