Park House

We found the following examples of good practice.

¿ The people who used the service had been consulted and kept informed throughout the COVID-19 pandemic. Associated person-centred care plans and risk assessments were in place and consent had been sought for testing and vaccinations. People had been consulted on whether they wished to remain as one household or spilt into smaller bubbles.

¿ Staff had supported the people who used the service to keep in regular contact with those they loved. A variety of methods were in place as per government guidance including outdoor visits, indoor visits, window visits, virtual video calls, letters, photographs and emails. A social media site for the home was updated regularly to provide reassurance to family members.

¿ The service had robust policies and procedures in place relating to infection prevention and control that we observed being adhered to during our inspection. They were in line with all current government guidance.

¿ There was clear signage in place for all visitors to the home that explained what processes were in place to ensure they did not introduce and spread COVID-19. We saw these being adhered to during our inspection when district nurses visited the service. We saw a symptom check was completed and that evidence was sought of a recent and clear negative COVID-19 result from a lateral flow test as required by current government guidance.

¿ The home was visibly clean throughout with procedures in place to ensure all areas were effectively cleaned on a regular basis. A person who used the service told us their room was cleaned every day and that it always remained clean and hygienic.

¿ Staff demonstrated good knowledge in infection prevention and control and staff leads for this topic were in place. We saw that social distancing was in place and that staff wore personal protective equipment (PPE) as per government guidance. A staff member was able to correctly explain how to don and doff PPE.

Park House is a residential care home providing personal care to 22 people at the time of the inspection. The service can support up to 26 people. The home can accommodate both younger and older people and accommodation is in an adapted period building over two floors.

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

People, and their relatives, consistently told us they received a high-quality service at Park House and that they would recommend it. One person who used the service said, “I think it’s very good here. From my point of view, the home looks after people well.” Staff at all levels demonstrated an exceptionally caring approach that made people feel safe, comforted and valued. People told us they were listened to, involved in all decisions and respected. One relative who provided us with feedback said, “[Family member] is very fond of the staff, they show great affection towards them and always have time for them.” Another relative told us, “We couldn’t be happier with Park House and all the wonderful staff, from the managers to the cleaners to the maintenance staff. I know that if the care was not so attentive, [family member] would not still be with us.”

The service assessed people’s needs holistically and with their full involvement and care plans were designed to meet those needs. Care plans were individual to each person and reviewed on a regular basis. Staff knew people’s needs and preferences well resulting in a tailored service. The service understood the importance of meeting people’s leisure and social needs and had invested resources into this meaning a full and varied activities programme was available. People’s consent was sought consistently, and people were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff had been safely recruited and the people who used the service had been involved in this process. People told us there were enough staff to meet their needs although some said there were busy periods where staff were not so available. The risks to people, visitors and staff had been identified and mitigated. This included those in relation to specific health conditions, environmental factors and those associated with working practices. Procedures were in place to help protect people from the risk of abuse and infection.

People received their medicines safely and as prescribed and their health needs were met. People told us they enjoyed the food provided, that they had choice and plenty to eat and drink. When accidents occurred, these were assessed to prevent reoccurrence and help protect people from harm. People told us they had no need to complain but would feel comfortable in doing so should the need arise; a policy was in place to manage any such complaints. Where people had specific communication needs, these were met on an individual basis.

All the people we spoke with talked highly of the staff and management team that supported them. They told us they had confidence in them, that they were well trained and knew them well. Staff agreed that they were well supported and felt valued. This had resulted in a positive, encouraging and supportive culture which benefited all. People, staff and visitors supported one another, and mutual respect was evident. The management team demonstrated a commitment to the service and procedures were in place to monitor and improve the service. They welcomed suggestions and opened the home to several other organisations to forge relationships that benefited those that lived there.

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 8 November 2016)

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.

There was not a registered manager in post. 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 current manager was in the process of undergoing the registration process through CQC, and had been in post since May 2016.

Staff understood what protecting people from harm or abuse was, and this was reflected in training records. Staff understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety. People were safely supported to take their medicines by trained staff.

There were detailed risk assessments within care records concerning risks associated with individuals. These included guidance for staff on how to mitigate these risks. Staff were confident in reporting incidents and accidents should they occur. The appropriate checks and maintenance in relation to people’s living environment were carried out. There were effective processes in place to minimise risk of harm.

Safe recruitment processes were in place to ensure that people employed in the service were deemed suitable for the role. There were enough staff to keep people safe.

People told us and our observations showed that staff were kind and caring. Staff had good knowledge about the people they cared for and understood how to meet their needs. Feedback from people and their relatives about the care they received was complimentary.

People planned their care with staff and relatives, and staff respected privacy and dignity. People were supported to access healthcare wherever necessary and in a timely manner, with prompt action taken in response to changes to a person’s health needs.

Staff supported some people to follow their interests and hobbies. There was regular visiting entertainment; however there was not as much stimulation for people who preferred to stay in their rooms.

People received enough to eat and drink, and received specialist diets in line with recommendations such as speech and language therapy. Food and drink was available throughout the day, and people received a good choice of meals. Staff also supported people to have their own food and drink which they purchased themselves when they wished.

Staff understood the importance of gaining people’s consent to the care they were providing to enable people to be cared for in the way they wished. Some people had authorisations applied for the lawful deprivation of their liberty (Deprivation of Liberty Safeguards (DoLS) and staff were able to explain how they promoted choice where people had variable capacity. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).

Staff were motivated and spoke positively about their job and understood the importance of providing a high standard of care to the people living in the service. Staff told us that there was good teamwork within the service, and that they felt supported in their roles.

The service had quality assurance systems in place to assess, monitor and improve the service. These included auditing systems and ways of gaining feedback from people about the home.

Below is a summary of what we found. This summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them, people's relatives and from reviewing records.

Is the service safe?

People were very satisfied with how their support and care needs were being met. There was a well established system of risk assessment in place to support people's needs. No-one we spoke with living in the home had experienced feeling unsafe or unsure. Having regular staff added to this sense of security and safety.

We found staff were trained and supported to safely do their job. The provider managed a rolling programme of training and staff could also ask for additional training if required.

CQC monitors the operation of the Deprivation of Liberty Safeguards [DoLS] which applies to care services. No applications have needed to be submitted. Adequate policies and procedures were in place relating to DoLS. Staff had been trained to understand when an application should be made, and how to submit one.

We found the home was well maintained and clean. This helped reduce the risk of injury or harm.

We reviewed staff rotas and found that there were sufficient staff on duty during the day and night to help keep people safe and free from harm.

People were provided with safe and appropriate support and care by a sufficient number of staff. People who used the service said that they had confidence in the capabilities of members of staff.

Is the service effective?

Park House demonstrated that it took great care to ensure the care and wellbeing of the people who used the service. This was shown in individual care plans, continuing risk assessments and daily records. Where it had been possible, we saw evidence of people being involved in decisions about their care and that their needs and wishes were known. We saw that members of staff actively consult people about their care and effectively carried out people's stated wishes.

We noted that other healthcare professionals worked with the home to ensure continuity of care where necessary.

People who used the service were satisfied with how they were actively consulted about their support, care and treatment.

Is the service caring?

People told us that they were very satisfied with the standard and quality of their support and care. By observing staff we found them to be kind, considerate and respectful towards people living in the home.

We noted that people were supported respectfully and courteously. We also noted that people were regularly spoken with in a polite manner by staff. Smiles and words of comfort were offered and interactions seen to be understood. Care and support provided was individual and informative.

Staff were aware of people's preferences, interests and needs.

Is the service responsive?

We saw that the home responded to people on an individual basis. People's likes/dislikes were acted on and we saw that every effort was made to put the interests and wellbeing of the individual first. One person we spoke with said 'I told them I wanted to get my hair done today. They arranged for the hairdresser to come in. That's nice, isn't it."

We noted that whilst staff were busy during the inspection that they still took time out to re-assure people, interact with them and generally engage with them.

Food was home cooked, could be eaten in private or in the dining room. People were free to choose where they ate.

Park House had a full and varied programme of activities for people to take part in, should they wish to.

We saw that people's individual care and treatment needs were assessed and planned for. Their individual choices and preferences regarding their support and care were valued. In addition, there was an effective system in place to respond to people's complaints, should it be needed.

Is the service well led?

The quality assurance system in place was robust. Staff said that they felt supported and trained to safely do their job.

We found that people's personal care records, and other records kept in the home, were accurate, safe and filed appropriately and securely.

Members of staff and people who used the service were provided with both formal and informal opportunities to share their views about the standard and quality of the service provision, and these were acted on, where needed.

The service was regularly audited and reviewed by the provider and prompt action taken if shortfalls were identified.

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

People who used the service that we spoke with were happy with the care and support received. One person told us, "Everyone is very nice, it's first class." Another person we spoke with told us that, "I can always ask if I want anything."

We looked at the care records of three people who used the service. These were comprehensive and detailed the health and social care needs of the person and how any possible risks were minimised.

The premises were clean and well maintained and recent improvements had included a new dining room floor and a new bath which was suitable for people with mobility difficulties.

The staff we spoke with told us about the range of training they had received and the support that management gave them. This meant they had the necessary skills to provide the care and support needed by the people who used the service.

We discussed the complaints procedures in place with people who used the service and with the provider. People told us they knew how to raise concerns but had not needed to do so.