St George's Park Limited

St George’s Park Limited is a domiciliary care agency. It provides personal care to people living in their own homes within the St George’s Park retirement community. On the day of the inspection the service was supporting 40 people with a range of health and social care needs, such as people with a physical disability, sensory impairment or people living with dementia. Support was tailored according to people’s assessed needs within the context of people’s individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes. Not everyone using St George’s Park Limited receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service:

People were happy with the care they received, felt relaxed with staff and told us they were treated with kindness. They said they felt safe, were well supported and there were sufficient staff to care for them. One person told us, “They are very good at what they do, we are very fortunate to have this service”.

People’s independence was promoted and told us their needs were met. They told us that they had a regular team of care staff who arrived on time and knew them well. One person told us, “They are very pleasant and kind, I have no concerns about their conduct”.

People felt they were offered choice in the way their care was delivered and that they had no concerns around their dignity and privacy in their own homes being respected. One person told us, “They are always very polite and respectful”.

Staff had received essential training and feedback from people indicated that they knew the best way to care for people in line with their needs and preferences. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider had systems of quality assurance to measure and monitor the standard of the service and drive improvement. These systems also supported people to stay safe by assessing and mitigating risks, ensuring that people were cared for in a person-centred way and that the provider learned from any mistakes.

People told us they thought the service was well managed and they received high quality care that met their needs and improved their wellbeing from dedicated and enthusiastic staff. One person told us, “It’s a well-run service, the manager is new in her role, but I’ve known her for a long time”.

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

Rating at last inspection: Good (report published 5 January 2017).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

St George’s Park Limited is registered as a domiciliary care agency, providing personal care to people in their own homes within the St George’s Park retirement community. They provide services to any people needing care and support who live in the apartments on the retirement homes site. St George’s Park is a community of retirement apartments set in lovely grounds in East Sussex. There were approximately 24 people receiving support to meet their personal care needs on the day we inspected.

There was a registered manager based at the service. 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.

People said they felt safe when receiving their support from St George’s Park Limited and knew who to contact if they had any worries about their safety. The provider had safeguarding procedures in place that were easy for staff to follow. Staff understood what their responsibilities were in safeguarding people within their role. They knew who to report their concerns to and were confident they would be listened to.

Risks to individual people and their circumstances had been identified, with actions put in place to reduce the risk and maintain people’s safety. Some of these were detailed, with step by step by guidance to manage the risk, however some were less detailed. We have made a recommendation about this.

People’s home environment, inside and outside, had been checked for hazards before their support commenced, helping to keep people and staff safe. Most people did not need help from staff to take their medicines, as they managed this themselves or family and friends helped, however some people did require support. Staff had the training necessary to equip them with the skills to safely administer medicines to people.

The provider had robust recruitment processes in place to make sure new staff were suitable to work with vulnerable people in their own homes. Enough staff were employed to be able to run a service that was responsive to people’s needs. People told us that staff were always on time when visiting and always stayed to support them for the whole time they were allocated.

New staff had an induction to make sure they were confident and competent before supporting people for the first time. This included shadowing an experienced member of staff. However, these shadowing shifts were not formally recorded to evidence that they had actually happened. We have made a recommendation about this.

Staff had suitable training at induction when they were new as well as regular updates. Most of the training was face to face training, delivered by the provider’s in house trainer who was based on site. Additional training was available to make sure staff were skilled and confident to cater for specialist needs, such as to support people with diabetes. Staff had ‘spot checks’ to make sure their practice continued to be safe and of good quality as well as one to one supervision.

Although most people looked after their own health care needs or had a family member who helped with this, staff supported some people who needed assistance when requiring health care appointments or advice. This was clearly evidenced through the recordings in people’s care records. Most people also managed their own meals or had family members who helped them. Where the need for support with nutrition and hydration had been identified, staff supported people with their meals and drinks through the day.

People told us they made their own decisions and choices and staff were clear that people were in control of their care and support. Mental capacity assessments had been undertaken where appropriate following the principles of the Mental Capacity Act 2005. People’s families were often involved if their loved ones needed support to make decisions.

There was clear evidence of the caring approach of staff. People were very positive about the staff who supported them, describing them as kind, caring and respectful. Some people told us they would not be able to manage without the staff. It was a small staff team so people had regular staff providing their care and support who had got to know them well, creating confidence and trust. People were given a service user guide at the commencement of their care and support with the information they would need about the service they should expect.

The registered manager undertook an initial assessment of people’s personal care needs so they could be sure they had the resources available to support people. People had a care plan that detailed the individual support they required to provide a guide for staff. People, and their families if appropriate, were involved in the assessment and care planning process to ensure the support in the care plan expressed how they wanted their care and support to be undertaken. Regular reviews of the care plan took place with the involvement of people and their family members.

How to make a complaint was included in the service user guide, and the people we spoke to knew how to make a complaint if they needed to. The provider asked people for their views of the service by asking them to complete a questionnaire once a year. The registered manager also checked that people were happy with the service provided when they regularly visited to provide care and support.

The people we spoke to thought the service was well managed and were happy with the service provided. People and their relatives knew the registered manager by name and were complimentary, saying they were happy to speak to her and always got a quick response.

Staff were happy with the support available for them and said that they were confident suggestions or concerns would be responded to if they had any. The registered manager said she got good support from her own manager as well as from other managers who were based in care homes on the same site.

The registered manager had a quality monitoring system in place to make sure the service provided remained safe and of good quality. They were planning to improve their system, introducing another auditing process to ensure they were responsive to making necessary improvements in the future. A range of monitoring processes were undertaken at various intervals including checking care plans and medicines administration records. People were asked their views of the service and the registered manager acted on the feedback provided to improve the quality of support to people.

People's privacy and dignity was respected in how their care was provided. One person told us 'They help me keep my dignity.' People told us that they had taken an active part in deciding what their care package should be.

People told us that their care and support had been well managed. One person said "I receive the help I need." Another said "I am helped in the way I want it done.' People told us that carers were punctual, and supported them in the way they wished to be supported. We saw that care plans showed that needs and risk assessments were in place which enabled care workers to support individuals in a safe and appropriate way. A member of staff told us 'People get very good care and get the care they need.'

There were arrangements in place to protect people from the risk of abuse. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening by arranging regular training for staff. Discussion with staff showed that they understood different forms of abuse and the systems in place to protect people from abuse.

Members of staff had received training and support which had helped them deliver care and treatment to people safely and to an appropriate standard.

People felt they could approach the service if they had any concerns or complaints. They told us that the manager regularly asked them for their views about the service and the care provided. People told us that their comments about the service were listened to and acted on.

People's support was planned and delivered in line with people's assessed needs and preferences. People and their relatives were involved in care planning. The manager regularly reviewed and updated people's care records to ensure they were accurate and fit for purpose.

People told us that they felt safe receiving care from the staff. People felt comfortable to raise any complaints or concerns although the people we spoke with said they did not have any. We found that people were safeguarded against the risk of abuse and neglect because staff understood how to identify and report concerns. The provider responded appropriately to complaints and safeguarding concerns.

We found that staff had received training and support. We spoke with three members of staff who told us they felt supported and had a high level of job satisfaction. However, we found that training updates were not monitored and most staff training was significantly out of date.

The provider maintained up to date records in a secure manner.