The inspection took place on 25 and 31 October 2017 and was unannounced. When we last inspected the service on 14 August 2015 we found that people’s medicines were not always managed effectively and safely and the systems in place did not always prove effective in monitoring and identifying errors with regard to the management of medicines.

Following the comprehensive inspection, the provider wrote to us to tell us how they would make the required improvements. At this inspection we found that the provider had made the necessary improvements and therefore improved the quality of the service provided at Parkview.

Parkview provides accommodation and personal care for up to six people who have a learning disability and the home was fully occupied on the day we inspected.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Accommodation is provided on one level and all areas of the service are accessible to wheelchair users. All bedrooms are for single occupancy and there are separate toilets and bathroom/shower facilities. There is a large kitchen, communal areas, including a dining room, a lounge and a conservatory for people and their visitors to use.

The majority of people who lived at the home were unable to communicate verbally but we observed staff supporting people with a range of communication aids, which included signing and interpreting people’s body language with regards to meeting their needs and wishes. People welcomed us into their home and we found people felt safe and happy living at Parkview.

We found that people were supported to take their medicines by trained staff. We saw that staff followed safe practices and medicines were accurately documented and stock levels checked were correct.

Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated thorough recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so.

People were involved in planning and reviewing their care and were encouraged to provide feedback on the service. Care was subject to on-going review and care plans identified people’s particular preferences and choices.

People were supported to play an active part in their local community and follow their own interests and hobbies. No formal complaints had been made since the last inspection took place but informal issues were dealt with appropriately and to people’s satisfaction.

We found that staff members received regular one to one supervision and felt supported and valued. People received the support they needed to eat and drink sufficient quantities and their health needs were catered for with appropriate referrals made to external health professionals when needed.

Relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The registered manager had arrangements in place to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. There was an effective system in place for people to raise complaints about the service they received.

There was an open and respectful culture in the home and relatives and staff were comfortable to speak with the registered manager if they had a conce

The people who live at Parkway did not have verbal communication skills. From our observations and discussions with staff we saw evidence that the staff we able to communicate effictively with the people and were ablet to recognise and meet the needs of the people living at the home.

Staff were appropriately recruited. The people lived in pleasant, well maintained clean home. The home had a complaints procedure in place.

We saw that the people were well cared for and that their health was promoted.

We were not able to converse with all the people who live at Turning Point due to their individual communication needs. People who could not answer our questions verbally gestured, nodded or shook their head in response to our questions.

People confirmed that staff understood them, and they liked living in the home. They were satisfied with the social activities available to them, and they liked their meals.

We found that the provider was meeting the standards we had inspected. Staff understood people’s needs and acted in a respectful and caring manner. People’s care plans and the risk assessments had been reviewed regularly and kept up to date. People were given a balance diet and their dietary needs were taken into account. Staff we spoke with knew where and how to report allegations of abuse. We saw that the home had systems in place to monitor the quality of service provided.

The people we spoke with during our visit on 09 December 2011 were not able to comment on the areas we looked at but were all calm and involved in a range of activities.

The inspection took place on 31July and 14 August 2015 and was unannounced. When we last inspected the service on 19 June 2014 we found them to be meeting the required standards. At this inspection we found that they had continued to meet the standards.

People living at the home and their relatives were positive about the home, the manager and the staff. Their feedback was sought and any suggestions were acted upon.

Parkview is registered to provide accommodation for up to 6 people with learning disabilities. It does not provide nursing care. At the time of our inspection there were 6 people using the service.

The assistant manager in post is currently in the process of applying to become the registered manager with the Commission. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection the home had made two application to the local authority.

Staff were trained in safeguarding people from abuse and systems were in place to protect people from all forms of abuse. Staff understood their responsibilities to report any safeguarding concerns they may have. Staff knew how to recognise and respond to allegations of abuse.

People were encouraged to remain as independent as possible and any risks related to this was assessed. Positive actions were taken to mitigate these risks. The provider was also monitoring risk for staff whilst delivering care at Park View and they developed risk assessments to ensure these risks were mitigated effectively.

There were enough staff to meet people`s needs effectively. Recruitment procedures were designed to ensure that staff were suitable and skilled to deliver care for people with mental health issues and checks were carried out before people started work to make sure they were safe to work in this setting.

Training was provided for staff to help them carry out their roles and increase their knowledge of the healthcare conditions of the people they were supporting and caring for. Staff were supported by the manager through supervisions and appraisals.

Staff had received training in the Mental Capacity Act (MCA) 2015 and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS ensure that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. Where people’s liberty needs to be restricted for their own safety, this must done in accordance with legal requirements. People’s capacity to give consent had been assessed and decisions had been taken in line with legal requirements.

People were supported with their eating and drinking needs and staff helped people to maintain good health by supporting people with their day to day healthcare needs.

Staff were caring and treated people with respect, making sure their dignity was maintained. Staff were positive about the job they did and enjoyed the relationships they had built with the people they were supporting and caring for.

People were involved in planning and reviewing their care and were encouraged to provide feedback on the service. Care was subject to on-going review and care plans identified people’s particular preferences and choices.

People were supported to play an active part in their local community and follow their own interests and hobbies.

No formal complaints had been made since the last inspection took place but informal issues were dealt with appropriately and to people’s satisfaction.

Staff understood their roles and were well supported by the management of the service. The service had an open culture and people felt comfortable giving feedback and helping Improve how it was run.

Although measures were in place to monitor all aspects of the quality of services provided and to reduce potential risks and drive improvement we identified a serious medication error which had been missed by the most recent medication audit carried out.