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Archived: Park House Community Care Good

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Reports


Inspection carried out on 19 April 2017

During an inspection to make sure that the improvements required had been made

Care service description

Park House Community Care provides care and support to adults in their own homes. The service is provided to mainly older people and some younger adults and people who have a learning disability. At the time of the inspection there were 24 people receiving support with their personal care. The service provided care and support visits to people in Folkestone, Hythe, the Romney Marsh and surrounding areas. It provided short visits to people as well as covering shifts over a 24 hour period to support people.

Rating at last inspection

At the last inspection, the service was rated Good and Requires Improvement in the 'Safe' domain.

Why we inspected

We carried out an announced comprehensive inspection of this service on 25 January 2016. A breach of legal requirements was found relating to managing risks associated with people’s care and support. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act Regulated Activities Regulations 2014, Safe care and treatment. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Park House Community Care on our website at www.cqc.org.uk

Why the service is rated Good.

People told us they felt safe when they received care and support from Park House Community Care. People and relatives were happy with the care and support people received. One person said “I am extremely lucky, they (staff) are very nice people and considerate. I really appreciate Park House”.

People received their medicines safely and when they should. There were systems in place to ensure medicines were managed safely.

Risks associated with people’s care and support were assessed and staff took steps to keep people safe. Equipment staff used was serviced regularly and monitored to ensure it was safe.

Staff knew how to recognise and respond to abuse. They had received training on how to keep people safe.

Accidents and incidents were very low in number, but were recorded and appropriate action taken to reduce the risk of further occurrences.

People were protected by safe recruitment procedures and had their needs met by sufficient numbers of staff.

Inspection carried out on 25 January 2016

During a routine inspection

The inspection took place on 25 and 28 January 2016, and was an announced inspection. The registered manager was given 48 hours’ notice of the inspection. The previous inspection on 2 and 4 December 2014 found breaches in medicines management and these had been addressed.

Park House Community Care provides care and support to adults in their own homes. The service is provided to mainly older people and some younger adults and people who have a learning disability. At the time of the inspection there were 21 people receiving support with their personal care. The service provided care and support visits to people in Folkestone, Hythe, the Romney Marsh and surrounding areas. It provided short visits to people as well as covering shifts over a 24 hour period to support people.

The service is run by an established registered manager, who also undertakes work at other services owned by the same provider. 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.

Risks associated with people’s care and support had been assessed, but assessments required regular reviews to help ensure people remained safe. People received their medicines when they should.

People were involved in the initial assessment and the planning their care and support and some had chosen to involve their relatives as well. Care plans contained information about people’s wishes and preferences. They detailed people’s skills in relation to tasks and what support they required from staff, in order that their independence was maintained. Care plans were reviewed periodically and reflected people’s current needs.

People felt safe using the service and when staff were in their homes. The service had safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe.

People had their needs met by sufficient numbers of staff. People received a service from a small team of staff. Staffing numbers were kept under constant review. New staff underwent an induction programme, which included relevant training courses and shadowing experienced staff, until they were competent to work on their own. Staff received training appropriate to their role and some staff had gained qualifications in health and social care.

People told us their consent was gained at each visit. People were supported to make their own decisions and choices. No one was subject to an order of the Court of Protection or had a Lasting Power of Attorney in place. Some people chose to be supported by family members when making decisions. Staff had received training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process.

People were supported to maintain good health. People told us how observant staff were in spotting any concerns with their health. The service worked jointly with health care professionals, such as community nurses and the mental health team.

People felt staff were very caring. People said they were relaxed in staffs company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approach and knew people and their support needs well.

People told us they received person centred care that was individual to them. They felt staff understood their specific

Inspection carried out on 2 December 2014

During a routine inspection

The inspection took place on 2 and 4 December 2014, and was an announced inspection. The manager was given 48 hours’ notice of the inspection. The previous inspection on 4 December 2013 was a follow up inspection, to look at previous breaches in the area of management of medicines. The provider had taken action and there were no breaches on the legal requirements at that time.

Park House Community Care provides care and support to adults in their own home. It provides a service to mainly older people and some younger adults and people who have a learning disability. At the time of the inspection it provided a personal care service to fewer than 20 people. It provided short visits to people as well as covering shifts over a 24 hour period to support people.

The service does not have a registered manager. 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. The service had been without a registered manager since November 2013. At the time of the inspection the manager had started to put their application together to submit to CQC to register.

People told us they received their medicines when they should. However we found shortfalls in some areas of medicine management. Where people were prescribed medicine “as required”, there was a lack of proper guidance to enable staff to administer these medicines safely and consistently. Where people were prescribed “one or two” tablets, we were unable to ascertain what had been administered as staff had not recorded this detail. Staff were applying creams as part of personal care routines, but there were no proper records maintained. You can see what action we told the provider to take at the back of the full version of the report.

People felt safe whilst staff were in their homes and whilst using the service. The service had safeguarding procedures in place, which staff had received training in. Staff demonstrated a good understanding of what constituted abuse and how to report any concerns.

People had their needs met by sufficient numbers of staff. People received a service from a small team of care workers. People’s visits were allocated permanently to staff rotas and these were only changed when staff were on leave. Staffing numbers were kept under constant review.

People were protected by robust recruitment procedures. Staff files contained the required information. New staff underwent a thorough induction programme, which including relevant training courses and shadowing experienced staff, until they were competent to work on their own. Staff received training appropriate to their role. However some refresher training had been delayed.

People were happy with the service they received. They felt staff had the right skills and experience to meet their needs. Staffs practice was monitored during unannounced checks on their practice. Staff felt well supported and attended supervision and team meetings.

People told us their consent was gained at each visit. People had also signed their care plan to confirm their consent to their care and support. People were supported to make their own decisions and choices. No one was subject to an order of the Court of Protection and people had the capacity to make their own decisions although sometimes people chose to be supported by family members. The manager and staff had received or were booked to attend training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant.

People were supported to maintain good health. People told us how observant staff were in spotting any concerns with their health. The service made appropriate referrals and worked jointly with health care professionals, such as community nurses.

People felt staff were “very caring” and “helpful”. People were relaxed in staffs company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approach and knew people and their support needs well.

People told us they received person centred care that was individual to them. They felt staff understood their specific needs relating to their age and physical or learning disabilities. Staff had built up relationships with people and were familiar with their personal histories and preferences.

People were involved in the initial assessment and the planning their care and support and some had chosen to involve their relatives as well. Care plans included people’s preferred routines, their wishes and preferences and skills and abilities. People said the manager or a senior member of staff visited periodically to review the care plan and discuss any changes required. People said their independence was encouraged wherever possible.

People told us that communication with the office was good and if there were any queries they called the manager and they always responded.

People felt confident in complaining, but did not have any concerns. People had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been positive.

People felt the service was well-led. The manager adopted an open door policy and took swift action to address any concerns or issues straightaway to help ensure the service ran smoothly.

The provider had a philosophy and vision. Staff were aware of these and felt the service listened and was very caring and promoted people’s independence, privacy, dignity and respect. Staff said they treated people how they would want to be treated.

Inspection carried out on 4 December 2013

During a routine inspection

On 3 October 2013 we inspected Park House Community Care and found non-compliance in the area relating to management of medicines. This was a follow up inspection to check compliance against that area. At the time of the inspection the manager told us that seven people were receiving a personal care service together with staff support with their medicines.

During this inspection we visited the office and spoke with the manager. We later spoke by telephone with one person who used the service, one relative and one member of staff.

People spoken with told us they continued to be satisfied with the service received. One person said, �I�m happy with the service�. A relative said, �It�s very good�. People said they got their medicines when they should.

Inspection carried out on 3 October 2013

During a routine inspection

We visited the office and spoke with the provider, the deputy manager and four members of staff. We later spoke by telephone with the six people who used the service, two relatives and five staff.

People told us they were able to make their own decisions and choices regarding their day to day care and support. One person said, �I am definitely in control�. People confirmed that they had given their consent and been involved in discussions about their care, sometimes with a family member, when the service had first started.

People told us they were satisfied with the service they received and felt that their care and support was personalised to their needs. One person said, �It�s the best care agency I have ever had�. Another person said, �It�s very good�. We found that care plans contained information about people�s needs and preferences. People knew about their care plan or confirmed that staff had talked about the care and support they required. Care was delivered by a small team of care workers to ensure people had continuity. One person said, �It tends to be the same one�.

Some people managed their own medications. Where staff were involved in the management of medication people told us they got their medication when they should. However we found shortfalls in the medication systems.

People said they had been asked for their views and feedback on the service provided. People told us they felt confident any concerns would be addressed. There were systems in place to monitor the quality of the service.

Records relating to people who used the service and staff were accurate, fit for purpose and held securely.

Inspection carried out on 4 February 2013

During a routine inspection

Park House Community Care was a small agency. We visited one person who used the service; spoke with five others and a relative. We also spoke with the provider, the deputy manager who assisted throughout the inspection and six staff.

People told us their privacy and dignity was respected and their independence encouraged. People said they had talked to staff about what care and support they required, before starting with the service and were satisfied with the care and support provided. One person said, �I am really happy with this agency and would recommend Park House to anyone�. Another comment was, �They�ve been absolutely brilliant, the best care agency I�ve had and I have had a few, they just go a bit further�.

People said they felt safe whilst staff supported them. They told us the service recruited the right calibre of staff and that staff had the right skills and experience to meet their needs. Most people felt they had been asked if they were satisfied with the service and thought their views were taken onboard.