Hundens Park is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during the inspection.
Hundens Park accommodates up to 47 older people in one building. People are accommodated over two floors, each of which have separate adapted facilities. The upper floor (Darnton Unit) provides support to people living with dementia. People with general nursing needs reside on the ground floor. On the day of our inspection there were 42 people using the service.
The inspection took place on 1 November 2017 and was unannounced. This meant staff did not know we were visiting.
We last inspected Hundens Park on 13 October 2015 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.
The service had a registered manager who was on duty during the course of our visit. 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.
Accidents and incidents had been logged but we could not verify at the time of the inspection whether the registered manager had oversight of any trends or analysis since May 2017. The registered manager told us they had changed their recording system and there had been some miscommunication between the management team as to who had responsibility for this oversight. On the day of our inspection the management team agreed to revert to their previous system which they told us had worked well.
We saw that actions required from a fire risk assessment in July 2017 carried out by an external contractor were not clearly recorded for action or follow up. On investigation we found issues in relation to major building works were not clearly recorded on the service’s ongoing action plan. This meant we could not see if it had been actioned or who was accountable. The regional director discussed this with the provider’s health and safety director and it was found the service was not responsible but this was down to the provider’s health and safety department not updating the recording system but the works had been actioned. This was rectified on the day of our visit by updating the service’s action plan.
We have made a recommendation about the quality of oversight and action plans.
Staff and the management team understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults. People we spoke with told us they felt safe at the home. The registered manager shared learning from feedback and safeguarding events with the staff team through recorded meetings.
Where potential risks had been identified an assessment had been completed to keep people as safe as possible. Health and safety checks were completed and procedures were in place to deal with emergency situations.
The home was clean, and we saw staff followed good practice in relation to wearing personal protective equipment when providing people with care and support. The environment in relation to the first floor had much improved and was much more homely, accessible and dementia focussed.
Medicines were managed safely. We saw medicines being administered to people in a safe and caring way. People confirmed they received their medicines at the correct time and they were always made available to them. We saw nursing staff working with community professionals to ensure end of life anticipatory medicines were available to people when needed.
We found there were sufficient care staff deployed to provide people’s care in a timely manner. We saw that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. The registered manager shared learning from feedback and safeguarding events with the staff team through recorded meetings.
Staff received the support and training they required. Records confirmed training, supervisions and appraisals were up to date. Staff told us they were supported by the home’s management but we saw that some staff meetings had lapsed over the busy summer holiday months. We saw the next staff meeting was scheduled within the next two weeks.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People gave positive feedback about the meals they were served at the home. People received the support they needed with eating and drinking by the chef who was trained in the support of people with nutritional needs.
We saw people’s healthcare needs were well monitored and records in relation to the monitoring of people’s health, nutrition and pressure care were recorded.
People were supported by care staff who were aware of how to protect their privacy and dignity and show them respect at all times. We saw end of life care being provided with compassion and additional staff supported the person and their family.
People’s needs were assessed before they came to live at the service and then personalised care plans were developed and regularly reviewed to support staff in caring for people the way they preferred.
An activities coordinator provided a range of activities and support for people to access the community.
People and staff were positive about the management of the home. Many staff had worked at the service for a number of years and this added to the feeling of a caring, well-run home.
The provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint. Feedback systems were in place to obtain people’s views about the quality of the service. We saw the service had a duty of candour file where lessons learnt and feedback was recorded.
The service had good links with the local community and local organisations.