This inspection took place on 15 and 16 January 2019. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Parkview Nursing Home provides accommodation with nursing and personal care for up to 88 older people, some of whom have dementia. At the time of this inspection there were 77 people using this service. Accommodation is provided over three floors with two modern lifts enabling access around the building. There were large communal lounges on each floor and dining rooms that were also used to provide day care during the week. The garden was well maintained and accessible for people.

Staff knew how to keep people safe and demonstrated a good knowledge of how to recognise abuse. Risk assessments were developed to minimise the potential risk of harm to people during the delivery of their care while still encouraging people to be as independent as possible. There were systems in place for the safe storage, administration and recording of medicines. Staff were recruited safely with appropriate checks on their backgrounds completed. All staff completed an induction programme and on-going training was provided to ensure skills and knowledge were kept up to date. All areas of the service were clean and well maintained. Cleaning schedules were in place and staff had access to personal protective equipment when required.

People’s needs were assessed and met by trained, supervised and appraised staff. People’s mental capacity was assessed and supported. People ate well and staff supported them to access healthcare services as necessary.

People and relatives told us staff were caring and kind. Staff respected people’s privacy and dignity and promoted their independence. People and staff shared positive relationships and visitors were made to feel welcome at the service.

Staff were responsive to people’s changing needs. People’s healthcare needs were detailed in their care plans. People engaged in a range of activities made available at the service. The provider managed complaints appropriately. Staff ensured that people were cared for compassionately at the end of their lives and in line with their preferences.

The service was committed to improving the robustness of its quality assurance processes so that action was taken where shortfalls were identified. Staff felt supported by the registered manager and encouraged to share their views regarding improvements to the service. The provider sought and responded to feedback from people and relatives and made information available to them. People benefitted from the provider’s partnership working with external organisations.

This was an unannounced inspection that took place on 10 and 11 May 2016. At the last inspection in May 2015 the service was meeting the regulations we inspected.

The home had 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 and associated Regulations about how the service is run. The registered manager was present on duty for the inspection.

The service had procedures in place whereby they assessed and identified risks to people’s health and safety. Appropriate risk management and support plans were developed to respond and to guide staff on how to keep people safe. Risk assessments and support plans were reviewed every month or where the person’s care needs had changed. Staff knew how to keep people safe and how to recognise signs of abuse. People and staff told us and we saw that there were sufficient staff numbers to meet people’s needs but acknowledged there were staffing shortages earlier this year which were now resolved.

People were supported by staff who were appropriately trained and skilled to meet their needs. Staff upheld people's rights and supported them in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff followed protocols and ensured people who lacked mental capacity were not unlawfully deprived of their liberty.

People told us they enjoyed the food and they got a choice. People’s nutritional needs were being met. People had access to outside health professionals when their health needs changed, but the service delivered by some community health professionals was not always satisfactory.

People and their relatives told us that this was a happy place to live. Staff provided people with the care and support they needed, this was delivered in a respectful way.

The home employed two activity coordinators; activities were available to all people living in the home. People were offered variety and could join in the numerous activities provided if they wished.

Staff were supported appropriately in their roles which enabled them to plan and deliver people’s care competently. The provider ensured suitable staff were recruited and appointed using robust recruitment procedures.

People using the service felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.

Areas of the environment were not satisfactory such as flooring, decor and a number of bathrooms required improvement. These had been identified by the provider and work was in progress in replacing flooring and attending to other areas of the environment indoors and maintaining the garden.

The organisation had systems in place to monitor the quality of the service, and we found these helped drive improvements. Feedback was obtained from people and areas for improvement were actioned as appropriate.

The majority of people using the service had complex needs which meant they were not able to tell us their experiences. We used other methods to help us understand the experiences of people using the service. We reviewed people's records, talked to staff, looked at satisfaction surveys, observed the care provided and spoke with visitors to the home on the day of our inspection.

From the surveys we looked at most people were satisfied with the care provided. Comments we saw ranged from, “My carer is good.”, “Some staff are better than others but are helpful in general.”, “The staff seem caring and friendly.” and “We feel all aspects are fully satisfactory.”

We observed from people’s records their care and support needs had been assessed and plans were in place to meet these needs. Risks to their health and wellbeing had been identified and plans were in place to manage these. We noted information about people was reviewed and updated regularly so staff had up to date information about people’s current care and support needs. Staff received appropriate training to keep their skills and knowledge up to date to meet these needs.

Medicines were administered appropriately and stored safely in the home.

People were provided with information about how to make a complaint if they were not happy with the service. Their views and experiences were sought and acted on by staff. The service had systems in place to monitor the quality of service that people received.

People who use the service and their relatives were mostly positive about their experience of living in the home. One person said ‘it's alright here, the people are kind' and another said 'the staff are quite nice , it's not bad living here, I’ve got a nice room, I get my washing done, I do mostly what I want’. One person told us they were ‘looked after very well’ and ‘I like the food’ and another person said ‘no complaints about staff. Only got to ask if you want something’. A relative of a person using the service told us ‘They take good care of mum. Staff are friendly and helpful and seem to be well trained’.

The majority of residents in Parkview Nursing Home were suffering from dementia, or at least a degree of confusion, and would find it difficult to make any real choices about their care and treatment. However those we spoke with, that were able to respond to us, agreed that staff ask them on a daily basis about their preferences and that they are always supported in a way which suits them. They told us that personal care is delivered in their own rooms and we saw that staff were generally very discrete and sensitive to their needs, leading them away gently to attend to them.

Relatives we spoke with were able to explain the pre-admission process and said that they had been given written information about the home which had helped them when they were making their choices.

People generally told us that they were happy with the care that they receive, everything is done as they like it, and there are activities to do. However one relative told us that there was not much in the way of activities for people who remained on the top floor dementia unit during the day.

Most of the residents who were able to talk to us told us that the food was good. Information had not been left with them to remind them about the choices that they had made. For those residents who were sitting in the communal areas there were drinks readily available however we noted that this was not always so for those who were in their rooms. One resident told us that staff never leave her any water in her room even though she keeps asking them and another complained that she was very thirsty and we saw that she had not been left a drink either.

People told us that they not have any concerns about medication and they felt safe living in the home. They said staff were always very nice and kind to them.

Relatives we spoke with described that staff as “absolutely wonderful”, “they are all so kind, we have never seen anything going on that we didn’t like”.

Most people were able to talk with us said that they never had to wait too long for people to come and help them although one person expressed some concerns about the weekend staffing levels. They said “there are sometimes problems when there are no officials here, it makes me worry about what might happen in the night”.

This inspection took place on 20 and 27 March and both visits were unannounced.

Parkview Nursing Home provides accommodation for up to 88 people who require nursing care and support on a daily basis. The home specialises in looking after adults over the age of 65 with dementia. There were 76 people using the service at the time of our inspection.

We last inspected the service in September 2013. At that inspection we found the service was meeting all the regulations that we assessed.

There was a registered manager in post at the time of our inspection, but they were on leave. 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 of feeling safe. The provider had procedures for ensuring that any concerns about people’s safety were reported and managed appropriately. Staff were knowledgeable about individual’s needs and interacted with them positively.

People’s care needs were accurately recorded with clear guidance for care staff to follow on how to support them. The home contacted other healthcare professionals if they had concerns over people’s needs.

A number of the people at the service were living with dementia; staff were suitably skilled in dementia care and positively supported people. Staff were guided by information within people’s care records. The records included individual information on issues that could trigger any behaviour episodes.

People were treated with dignity and respect, and staff were gentle when moving and handling people. Staff respected confidentiality and had discreet conversations with people about private matters without other people listening to their conversations, staff made sure that doors were closed during personal care.

People were offered opportunities to take part in a range of suitable activities that they enjoyed. They found staff had the time to support them with their hobbies and interests.

Staff were responsive to people’s needs. They had a good knowledge and understanding of peoples’ support needs and took prompt and appropriate action to respond to any concerns or changes in their conditions.

The service showed respect for individual’s religious and cultural needs. They promoted equality and diversity in care arrangements. There was good knowledge among staff of people’s religious and cultural needs.

Complaints were dealt with appropriately, compassionately and in a timely fashion in line with the policy. People’s opinions were sought and acted upon to improve the service. Regular “residents’ and relatives’”meetings were held for people to voice their opinions and make suggestions, the provider responded positively to suggestions for improvements.

People found the management team accessible and approachable. People told us they felt listened to and could change things about the service.