This was an unannounced inspection, which meant no one related to the home knew we would be inspecting the service that at the first visit. The inspection took place on 27 and 30 April 2018.

The Parklands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Parklands provides accommodation for up to 40 older people, some who are living with dementia. The home is situated in the Thorne area of Doncaster. At the time of the inspection 22 people were living at the home.

At the last inspection in November and December 2016 the service was rated Requires Improvement. This was because we identified shortfalls in staffing, staff supervision, meals and maintenance. These issues had not been identified by the registered provider through the monitoring system in place at that time, or where they had, action had not been taken to address them in a timely manner. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection we asked the registered provider to complete an action plan to show what they would do and by when, to improve the key questions Safe, Effective and Well Led to at least good. At this inspection we found a marked improvement in most of these areas. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The service did not have a registered manager in post at the time of our inspection. 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. The registered provider had appointed a new manager and they told us they were applying to be registered with the Care Quality Commission.

At this inspection people who used the service and the visitors we spoke with told us they were happy with how care and support was provided at the home. They spoke positively about the staff and the way the home was managed. People told us they felt safe living in the home. We saw there were systems in place to protect people from the risk of harm.

Staff we spoke with were knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified any potential risks to people and care plans were in place to help ensure people’s safety.

Medicines were stored appropriately and the audit procedures had been improved. There was enough skilled and experienced staff on duty to meet people’s needs.

There was a safe recruitment process and new staff received an induction into how the home operated and their job role, at the beginning of their employment.

Staff had access to training that met the needs of the people using the service. However, some staff needed more support to complete the e-learning programme that was available.

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.

People were provided with a choice of healthy food and drink ensuring their nutritional needs were met. People said they were happy with the meals.

People’s needs had been assessed before they moved into the home and they and their relatives were involved in planning their care. The care files we checked reflected people’s needs and preferences, so staff had clear guidance on how staff should provide care to them.

People had access to a programme of activities and entertainment, as well as trips out into the community.

People said the

The inspection included two visits to the home, which took place 18 and 19 July 2017. The first of these visits was unannounced. The last inspection took place on 28 November, and 5 and 9 December 2016. The service was rated Requires Improvement. The areas identified as requiring improvement at that time were in relation to deployment and support of staff, the effectiveness of the quality audit, and redecoration and repair of the home.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘The Parklands Care Home’ on our website at ‘www.cqc.org.uk’.

The Parklands Care Home provides accommodation for up to 40 older people, some who are living with dementia. The home has two distinct areas, the main area of the home and a smaller area where people had a higher level of need and were living with dementia. The smaller area is referred to as unit 2 by the staff and visitors to the home. The home is situated in the Thorne area of Doncaster. At the time of the inspection 27 people were using the service.

The service did not have a registered manager in post at the time of our inspection. 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. The previous registered manager had recently left the service and the registered provider had recruited a new manager. A team leader was running the home on a day to day basis until the new manager came into post.

Although staff worked well as a team, most told us they were not always able to respond to people’s needs, because there were not always enough staff around to enable them to do so. People’s relatives also expressed concern about the numbers of staff available.

We saw that medicines were not always managed in a safe manner.

Not all risks associated with people’s care had been identified and action had not always been taken to reduce these risks.

For the most part, people were supported to make decisions about their care and their choices were respected. Care plans included information about people’s likes and dislikes.

Staff received support and supervision to help them meet people’s needs. Staff completed training and received periodic refresher sessions, although there was a need to provide training to staff in caring for people at the end of their life and some staff needed further training in the Mental Capacity Act (MCA).

People were supported to maintain good health and received on-going healthcare support. Overall, people received a nutritious and balanced diet. Snacks and drinks were offered throughout the day.

We observed staff interacting with people who used the service and found they were respectful and caring and very committed to people’s welfare. People we spoke with liked the staff and got on well with them.

A good range of social activities were provided in the home and there was an activity co-ordinator who had built particularly positive relationships with people.

There was a complaints procedure and people we spoke with told us they would talk to the manager or staff if they had a complaint.

People who used the service were involved in the development of the home and were able to contribute ideas. We saw audits took place to ensure policies and procedures were being followed, although the registered provider had not always responded in a timely way when repairs were identified as needed.

We found three breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of governance, staffing and the management of medication. You can see what action we told the registered provider to take at the end of this report.

The inspection included three visits to the home, which took place on 28 November, 5 and 9 December 2016. The first of these three visits was unannounced. The last inspection took place in May 2016 and we identified no breaches of regulation at that time.

The Parklands provides accommodation for up to 40 older people, some who are living with dementia. The home is situated in the Thorne area of Doncaster.

The service did not have a registered manager in post at the time of our inspection. 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. The registered provider had appointed a manager and the manager had told us they were applying to be registered with the Care Quality Commission. However, at this inspection they told us that they were leaving their post and no longer pursuing their registration. This meant that the home had been without a registered manager for a significant period of time.

Although staff worked well as a team, most told us they were not always able to respond to people’s needs, because there were not always enough staff around to enable them to do so.

The manager had a plan in place to make sure that all staff were up to date with all aspects of their training. However, they had not been able to provide all staff with formal, one to one supervision as regularly as they should. Additionally, the manager themselves had not received professional supervision in all the time that they had been in post.

We saw that quality and safety audits took place, but they were not always effective and the registered provider had not always responded in a timely way when improvements were identified as needed.

There was a policy to protect people from abuse. Staff had received training in this area and knew how to recognise and respond to abuse.

We saw that people received their medicines in a safe manner.

Risks associated with people’s care had been identified and action had been taken to reduce the risk from occurring.

People were supported to make decisions about their care and their choice was respected. Care plans included information about people’s likes and dislikes.

Overall, people received a nutritious and balanced diet. Snacks and drinks were offered throughout the day.

People were supported to maintain good health, have access to healthcare services and received on going healthcare support.

We observed staff interacting with people who used the service and found they were calm, respectful and caring. People we spoke with liked the staff and got on well with them.

A good range of social activities were provided in the home and there was an activity co-ordinator. We saw lots of events had been organised.

There was a complaints procedure and people we spoke with told us they would talk to the manager or staff if they had a complaint.

People who used the service were involved in the development of the home and were able to contribute ideas.

We identified a breach of the Regulations in relation to governance. You can see what action we told the provider to take at the end of this report.

The inspection took place on 3 May 2016 and was unannounced. The home was registered with the Care Quality Commission in July 2015 and this was their first inspection.

The Parklands provides accommodation for up to 40 older people, some who are living with dementia. The home is situated in the Thorne area of Doncaster.

The service did not have a registered manager in post at the time of our inspection. 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. The provider had appointed a manager and they were in the early stages of applying to be registered with the Care Quality Commission.

The provider had a policy to protect people from abuse. Staff had received training in this area and were knowledgeable about how to recognise and respond to abuse.

We saw that people received their medicines in a safe manner. We looked at records in relation to medicine management and found each person had a medication administration record (MAR) in place. This clearly evidenced when people had been given their medicines.

Risks associated with people’s care had been identified and action had been taken to reduce the risk from occurring.

We saw that there was enough staff around to ensure people’s needs were met. Staff worked well as a team and were able to respond to people’s needs. The provider had a staffing tool which was used to determine the correct number of staff to be on each shift.

We looked at records in relation to training and spoke with the manager. The manager told us they had found it difficult to ascertain what training staff had completed prior to her working at the home. The manager showed us a plan she had put in place to ensure that all staff were up to date with all aspects of training.

People were supported to make decisions about their care and their choice was respected. Care plans included information about people’s likes and dislikes.

People received a nutritious and balanced diet. Snacks and drinks were offered throughout the day. We spoke with the cook who was knowledgeable about the different dietary requirements people had, and provided meals to suit their needs and tastes.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support.

We observed staff interacting with people who used the service and found they were calm, respectful and caring. People we spoke with liked the staff and found they got on well with them.

The manager was in the process of working with people and staff in updating people’s care plans and introducing new documentation. We looked at three care plans and found that in the main people’s needs were identified, reviewed and carried out.

Social activities were provided in the home and the provider employed an activity co-ordinator. We saw lots of events had been organised.

The provider had a complaints procedure and people we spoke with told us they would talk to the manager or staff if they had a complaint. We did not see any information displayed which would inform people how to complain or what the process was.

During our inspection we saw the registered manager interacted well with staff and people who used the service.

We saw audits took place to ensure policies and procedures were being followed, although these were in the early stages and required embedding in to practice.

People who used the service were involved in the development of the home and were able to contribute ideas.