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Inspection carried out on 12 June 2018

During a routine inspection

This unannounced inspection of Park House Care Home took place on 12 June 2018.

At the last inspection in June 2015, the service was rated ‘Good’. We found during this inspection that the service remained ‘Good.’

Park House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Park House Care Home is registered to provide accommodation for a maximum of 29 people who require help with their daily lives such as assistance with personal care and who may be living with dementia.

The two-storey building is situated among pleasant grounds in a rural location near to Sandbach.

At the time of our inspection there were 26 people living at the home.

The home is registered as a partnership and has two registered managers who are closely related to each other. 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.

Both of the registered managers continued to be fully involved in the home despite their different roles and different responsibilities. An additional family member who was the deputy manager and undergoing training at our last inspection, was now fully engaged in their role and had oversight of the day to day running of the home.

There was limited information for people to support their understanding. We have made a recommendation concerning this.

Rotas showed there was enough staff at the home to support people safely. Practices relating to medication storage and administration were safe. Staff were able to describe the course of action they would take if they felt anyone was at risk of harm or abuse this included ‘whistleblowing’ to external organisations. The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely. Risks were well assessed and information was updated as and when required. We were able to view these procedures and how they worked.

All newly appointed staff were enrolled on a work based induction when they took up post at the home. Records showed that all staff training was in date. There was a supervision schedule in place, all staff had received up to date supervisions and most had undergone an annual appraisal, any due were booked in to take place.

We saw that where people could consent to decisions regarding their care and support this had been documented. Where people lacked capacity, the appropriate best interest processes had been followed. The service was working in accordance with the Mental Capacity and DoLS (Deprivation of Liberty) and associated principles. There was currently no one assessed as needing a DoLs.

The environment was pleasant and homely. There was limited consideration given to support people who were living with dementia. some additional attention would be encouraged in relation to the environment, this would improve the overall environment and support independence. We raised this at the time of our inspection.

People we spoke with were complimentary about the staff, the registered manager and the service in general. People and relatives told us they liked the staff who supported them. Staff were able to give us examples of how they preserved dignity and privacy when providing care and we observed staff treating people with kindness and dignity throughout the day.

There had been no complaints received for Park House. However, the complaints process was well managed and documented in accordance with the provider’s complaints policy. The complaints policy contained contact details for the local authorities an

Inspection carried out on 6 March and 20 April 2015

During a routine inspection

This inspection was unannounced and was started on the 6 March 2015 and a second announced visit to complete it was then undertaken on the 20 April 2015.

The home is registered as a partnership and has two registered managers who are closely related to each other. 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.

Both of the registered managers are fully involved in the home but have different responsibilities. One registered manager is more involved in the day to day delivery of care, for example, care plans, staff recruitment and training and often undertakes the cooking. The other takes responsibility for the practical issues, for example the on-going maintenance of the home and for dealing with any contractors used. In addition to the registered managers and as part of the long term planning for the future of the home another close family member was acting as the deputy manager and had recently taken over some of the day to day management responsibilities within the home, this included, staff training and supervision.

Park House Care Home is privately owned and is registered to provide accommodation for a maximum of 29 people who require help with their daily lives such as assistance with personal care. It is a two storey building located in a rural location on the outskirts of Sandbach. The town centre is approximately one mile from the home. On the first day of our inspection there were 28 people living in the home.

People living at the home, relatives and staff were positive about the services provided at Park House. We observed how staff spoke and interacted with people living at the home and found that they were respectful, kind and patient offering various choices throughout the day.

The staff members working at the home had a good understanding of the need to ensure people were supported to stay safe. They told us that they were aware of safeguarding and would report any issues of concern.

Medicines were organised and audited monthly to ensure safe practices were maintained and people were given any medicines as prescribed.

We found care plans to be up to date and individual to the person whose plan it was. They had been regularly reviewed and checked by senior staff to ensure records were appropriately kept up to date. They contained guidance to enable staff to know how to support each person’s needs. Staff had a good understanding and knowledge of the people they supported.

People living at Park House told us that they could raise their opinions and discuss any issues with staff. The service had a complaints procedure in place.

The home operated safe recruitment processes and ensured that staff members employed were suitable to work with people living at Park House.

Staff members were receiving training and supervision to assist them in their job roles and in their personal development. Training records and supervision for staff had recently been updated to improve the accuracy of records to show what training staff had received and when staff were due refresher training.

Various audits and maintenance checks were carried out on a regular basis by the registered managers and senior staff to help ensure that appropriate standards were maintained throughout the home. The people we spoke with who lived at the home, relatives and staff were positive about the service and how it was managed.

Inspection carried out on 5 September 2013

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

We did not speak to people at the service during this inspection.

On our previous visit we found that the provider was not notifying the Care Quality Commission when residents died as required by the regulations.

During this inspection we assured ourselves that this was no longer the case and that required notifications would be made.

Inspection carried out on 10 May 2013

During a routine inspection

During our inspection we spoke to five people about their experience of living in the home. No-one expressed concerns and most were complimentary. One person told us that they were “treated properly” and that they had a “nice time.”

A second person said it was “alright here”, that there were “enough staff”, that they were “not kept waiting” and that they would “advise friends to come here.”

Someone else said there was “nothing to grumble about” and that they were “very happy here”. They also said staff were “really nice and do as they are told; they do everything I want”. When asked about the food they said “I can’t find fault it” and when asked about drinks that they “get plenty”.

We looked at people’s files and found that their needs were assessed and regularly reviewed as were care plans.

We saw that the kitchen was clean and safe and that staff had received appropriate training. People’s dietary needs were assessed and if necessary special diets were provided.

The home was clean and tidy. The home employed a lead for Infection Prevention and Control and had appropriate policies which were followed.

Recruitment was carried out properly and information was kept on file in accordance with the regulations.

We found that the provider had not informed CQC of deaths that occurred as required by the regulations although this did not raise any concerns about the care of people who lived there.

Records were kept securely and were available when needed.

Inspection carried out on 24 April and 3 May 2012

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

We spoke to a person who had been resident in the home for a number of years. They told us they could get up in the mornings when they wanted and they said that they now got up later than they used to.

We spoke to another person who had spent two years in the home. They said the home was “very nice”, that staff “treat you as a person” and “you don’t feel like you are in a home”. They also said that staff “always said ‘would you like to’ before doing things”.

We spoke to a relative of a person living in the home. They said they were “very pleased and impressed”. They said that meals could be adapted to personal needs and told us of a resident they knew whose specific cultural dietary requirements were accommodated. They told us of how their relative’s needs had been asked about before they came to the home and that this involved them and not just their representatives.

We spoke to the relatives of a person who was just moving into the home on the day we visited. They told us that the home had met with them and the resident beforehand and talked about preference and care needs. We saw that a pre-assessment document had been started and that more information was being provided by the family.

Another resident told us that staff treated people “decently” and that they took account of the fact that “everyone’s needs are different.”

A fifth person told us that if they wanted a bath they could “always have one” and that “visitors are made to feel welcome”.

We spoke to a person who had been resident in the home for a number of years. They said that it was “very good, the best”. They told us that they “get a lot of comfort” and that they “get a bath enough”. They also said that there was a choice of meal and if they didn’t like it something else would be prepared for them.

Another resident told us that they were “satisfied” and that people get “help when they need it”. This person said that they had been involved in the care of older people and that they could see that “things were done right”. They told us of their medical condition and that the home “takes account of it”, supporting them to see their GP and specialists.

We spoke to a relative of a person living in the home. They said “the standard of attention is excellent” and told us they thought there were always enough staff. They told us of their relative’s medical needs that required a particular piece of equipment. They said the home had worked with the supplier to get staff training and also a duplicate item to enable them to have more flexibility and opportunity to use the home’s facilities.

We spoke to a relative of someone who had only been in the home for a couple of days. They said the home was “pleasant” and that “he gets what he wants”. We asked about any concerns and were told that when they visited a few days earlier they had been concerned that his food had not been cut up, something that had been discussed in the pre admission assessment. They told us they pointed this out and it was immediately addressed. We took the opportunity to observe the mealtime and noted that this person’s food was served to them cut up as they needed.

We spoke to a person who had been resident in the home for a number of years. We asked if they ever had any worries or whether they ever heard raised voices. They said there was “nothing untoward” and if they did have any concerns they would speak to the manager or a senior carer.

We spoke to another person who had spent two years in the home. They replied “no” when asked if they had any worries and if they ever heard raised voices in the home.

We asked a relative of a person living in the home if they had any worries about their safety and they said not.

We asked a relative of a person living in the home if they had ever needed to complain. They said not but that they had “brought issues” to the attention of the managers and been provided with “answers”. They said the managers were “open to comment” and if they had need to complain they were “confident that complaints would be dealt with”.

We spoke to another relative and they told us of a recent complaint that they had made. They did this by speaking to the care staff and the issue was resolved quickly.

When we spoke to people who lived in the home they said they felt confident to approach staff with issues.

Reports under our old system of regulation (including those from before CQC was created)