Park House Residential Care Home

Park House Residential Care Home is in Oldham, Greater Manchester and is operated by Park House Residential Care Limited. The home provides accommodation and personal care and is registered with CQC to provide care for up to 28 people. There were 28 people living at the home at the time of our inspection.

We found the following examples of good practice:

On arrival to the home, proof of a negative lateral flow test (LFT) was required and personal protective equipment (PPE) needed to be worn. A range of information was on display regarding hand hygiene and use of PPE. Visiting health care professionals needed to evidence they had received the COVID-19 vaccination.

Zoning arrangements were used if people needed to self-isolate in certain areas of the home, such as bedrooms. These measures had been utilised following the recent COVID-19 outbreak.

Testing arrangements were in place for both staff and people using the service’. All staff working at the home had received their COVID-19 vaccination which was a condition of deployment. Appropriate arrangements were in place for new admissions, such as requesting confirmation of a negative COVID-19 test and completing a period of self-isolation.

Enough PPE was available, and we saw staff wore it at all times during our visit. We observed the home to be clean and tidy, with domestic staff carrying out their duties throughout the day.

There were enough staff to care for people safely, with staff receiving additional infection control training during the pandemic. Agency staff were used to fill any gaps in rotas where regular staff were unavailable.

Risk assessments were in place where certain groups may be at higher risk of contracting COVID-19. An appropriate infection control procedure was in place, with specific reference to COVID-19. Regular infection control audits were undertaken to ensure standards were maintained.

We found the following examples of good practice.

When people were Covid-19 positive the service was able to cohort them on a different floor with their own staff whilst they were isolating.

One person who used the service, lacked capacity to consent to the test and was fearful of it. Their next of kin consented to them having the test and staff worked with them to give them reassurance and encouragement to have the test.

Further information is in the detailed findings below.

Park House is a residential care home providing personal care for up to 28 people. At the time of our inspection there were 26 people living at the home.

People’s experience of using this service and what we found

We have made a recommendation about the management of medicines, as some improvements are need in relation to medicines documentation. The registered manager has assured us of greater oversight of this area, so that improvements can be made promptly, embedded in practice and sustained in the future.

The service was well-led. The registered manager was supported by a team of staff who worked together to provide people with a good quality of service. The registered manager led by example and was respected by staff. Staff reported a high level of job satisfaction.

There was a warm and happy atmosphere at the home and people were supported by a committed and caring staff team. People were treated with dignity and respect.

There were systems in place to ensure only staff who were suitable to work with vulnerable people were recruited. There were enough staff to care for people and people told us they felt safe and happy living at Park House. Staff understood safeguarding procedures and had received training in recognising the signs of and types of abuse.

Everyone we spoke with was complimentary about the home and staff. People told us they knew how to raise a complaint, and were confident action would be taken. However, no one we spoke with had any concerns about the home.

The home was clean, well-maintained and nicely decorated. All servicing of equipment had been completed. Correct infection control practices were followed by staff.

Care was person centred and care plans contained a good level of information about people's needs and preferences. Risks to people’s health and safety had been assessed and were managed appropriately. People were supported to stay as healthy as possible and eat a balanced, varied diet. They were referred to health care professionals, when needed, for advice and guidance.

A variety of appropriate activities were provided and people were actively encouraged to participate in them.

Staff supported people to have maximum choice and control of their lives and supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Audits were in place to monitor the quality of the service. We discussed the concerns we found around medicines management with the registered manager, who told us she would increase her oversight of this area of care provision.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (report published 16 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had a manager in post who had registered with the Care Quality Commission in January 2016. They had previously been the deputy manager at the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers ('the provider'), 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.

At our last comprehensive inspection carried out in June 2015 we found the service was meeting all the regulations we reviewed.

People told us they felt safe in Park House. They were cared for by staff who were kind, caring and respectful of their dignity and privacy.

Care records needed to be improved to ensure they included more detailed guidance for staff to follow in order to meet people’s needs in a safe and appropriate manner. Some staff did not always use best practice when supporting people to mobilise within the home.

Staff had completed training in safeguarding adults and knew the correct action to take if they witnessed or suspected abuse. Staff told us they would be confident to use the whistleblowing policy that was in place should they witness poor practice in the service.

There were sufficient numbers of staff available to meet people’s needs, although communication between staff could be improved to avoid people waiting for the support they wanted. Most staff had been safely recruited although one person only had one reference on their personnel file; this was not in accordance with the provider’s own recruitment policy which stated staff would not start work at Park House until two references had been received.

Some improvements needed to be made to ensure people always received their medicines as prescribed and that medicines were stored at the correct temperature to ensure their effectiveness.

People were cared for in a safe and clean environment. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity or gas supply. Personal emergency evacuation plans were in place to help ensure people who used the service received the support they required in the event of an emergency at the home.

Records showed staff had received the necessary induction, training and supervision to help them to deliver effective care. The registered manager completed regular observations of staff in order to help ensure they were competent in delivering the care people required.

Staff had received training in the Mental Capacity Act (MCA) 2005. The registered manager had taken appropriate action to safeguard the rights of people who were unable to consent to their care in Park House. Six people’s care arrangements were authorised under the Deprivation of Liberty Safeguards (DoLS) at the time of this inspection.

Systems were in place to help ensure people’s health and nutritional needs were met. Staff worked in cooperation with health professionals to help ensure that people received appropriate care and treatment.

People were provided with the opportunity to engage in a range of activities to promote their well-being.

People were encouraged to provide feedback on the care they received in Park House. The registered manager met with people on an individual basis to discuss whether they were happy with the way staff supported them.

Staff told us they enjoyed working in Park House. They told us the registered manager and owners were approachable and supportive. Regular staff meetings meant that staff were able to make suggestions about how the service could be improved. Staff told us their views were always listened to.

There were systems in place to monitor the quality and safety of the service. The registered manager demonstrated a commitment to continuing to drive forward improvements in the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This should help reduce the risks to people and help the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Senior staff had been trained to recognise and understand when an application should be made, and in how to submit one. This meant that people using the service would be safeguarded as required.

The registered manager set the staff rotas and took into account people's care needs when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs should always be appropriately met.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in writing them and they reflected their current needs.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We observed care workers showing patience and giving encouragement when supporting people. People commented, "I don't have any concerns. I leave here and feel confident that they are looking after X".

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People had access to a range of activities both in the home and local community which were accessed on a regular basis.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a consistent and joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

The home had a policy in place about safeguarding vulnerable adults and measures were in place to ensure staff received appropriate training. Since the last inspection an internal review of staff understanding of safeguarding had taken place. A member of staff we spoke with confirmed their awareness of the policy and was able to correctly explain the process to be followed.

There was a clear line management structure in place. Over the past year a new training and personal development strategy had been introduced for staff. Management had plans to audit and review the success of the system at the end of the first year. This was to include an opportunity for staff to provide their feedback. Staff meetings for junior and senior staff were held regularly and staff were invited to contribute to the agenda.

We saw evidence that systems were in place to regularly assess and monitor the quality of services provided at the home.