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Inspection carried out on 20 December 2017

During a routine inspection

This inspection took place on 20 December 2017 and was unannounced. Our last inspection was in November 2015 where we rated the service as ‘Good’.

Queen Elizabeth Park is a nursing home providing support to a maximum of 77 older people. People living at the service had physical disabilities, long term medical conditions and many people were living with dementia. Care was provided across three floors in a purpose-built building.

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

There was 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.

Staff were committed to improving people's lives and they found innovative ways to do so. The provider found creative ways to encourage people to have fun and engage in activities they would enjoy. Care was planned and delivered in a person centred way and technology was utilised to achieve outcomes for people. Projects were undertaken in areas such as exercise and the provider built strong links with the local community which people benefitted from. These interventions had seen people develop confidence and skills. Staff understood the importance of promoting people’s independence and care was planned in a way that helped them to achieve this. Where people received end of life care, this was delivered sensitively and in line with best practice.

People received food that they liked and their dietary needs were met. People’s care plans were person-centred and reflected their needs and preferences. Risk assessments identified and managed risks people faced. Where clinical needs were identified, these were met by competent clinical staff. People’s medicines were administered in line with best practice and people had regular support from healthcare professionals, who worked alongside care staff to ensure people’s health was maintained. There were effective systems in place to manage the risk of the spread of infection and we found the home environment to be clean and staff were knowledgeable in this area.

Where accidents or incidents occurred, staff responded appropriately. Staff took actions to ensure that people were safe following incidents such as falls or illness. Staff understood how to respond if they suspected abuse had occurred and we saw evidence of them doing so. The provider analysed accidents and incidents as well as clinical needs and risks. Where patterns or trends were identified, appropriate actions to reduce risks were identified and implemented by staff.

People were supported by respectful staff that they got along well with. Staff had a good understanding of people’s needs and we observed pleasant interactions taking place during our inspection. Staff routinely involved people in choices about their care and the provider had systems in place to ensure that people could give feedback and make decisions wherever appropriate. The provider carried out a regular survey and a clear complaints procedure was in place and was known to people.

There were appropriate numbers of trained staff to meet people’s needs. Clinical staff got the support they needed to remain up to date with current practice. Staff received training to support them in their roles and had regular contact with their line managers. Regular meetings took place to involve staff in the running of the home and staff felt supported by the management.

Regular checks were carried out on the quality of the care that people received. The provider had a robust regime of audits in place that identif

Inspection carried out on 9 and 10 November 2015

During a routine inspection

Queen Elizabeth Park provides residential and nursing care for up to 77 older people and those who have needs associated with dementia. The home is purpose built providing accommodation on three floors, with the ground floor being for elderly frail people, the second floor being for people with nursing care needs, and the second floor providing care for people with dementia. There are a range of on-site amenities including a cinema, lounge areas, a bar, a hairdressing salon and a small library.

The home has 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.’

This inspection took place on the 9 and 10 November 2015 and was unannounced. There were 73 people living in Queen Elisabeth Park. There were 26 people living on the nursing unit, 25 people living on the dementia unit and 22 people living on the residential unit.

The home had an activity programme and staff who were part of an activity team. We observed that the activities were specific to each unit for small groups, guided by their specific social needs. There was also larger group activities for all units to join if they should choose to.

The care planning system had been reviewed and records for each person were specific to their needs, with guidance for staff to ensure people received the support and care they needed and wanted. Staff said the care plans were easy to follow on the computer system and that improvements were always being made as they continued to learn the system. For example adding particular medicines and the reasons prescribed. Nurses and senior care staff developed the care plans and all staff were expected to record the care and support provided and any changes in people’s needs. The manager said care staff were being supported to do this and additional training had been provided. Food and fluid charts were completed and showed people were supported to have a nutritious diet.

Staff and relatives felt there were enough staff working in the home and relatives said staff were available to support people when they needed assistance.

Pre-employment checks for staff were completed, which meant only suitable staff were working in the home.

Essential training and updates were provided for all staff, including safeguarding people, moving and handling, management of challenging behaviour, pressure area care, falls prevention and dementia care. Staff said the training was very good and helped them to understand people’s needs.

All staff had attended safeguarding training. They demonstrated a clear understanding of abuse and said they would talk to the management or external bodies immediately if they had any concerns, and they had a clear understanding of making referrals to the local authority and CQC. People said they were comfortable and relatives felt people were safe.

Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people’s needs were met. There were systems in place for the management of medicines and we observed staff completing records as they administered medicines.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider, manager and staff had an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff had a good understanding of people’s needs and treated them with respect and protected their dignity when supporting them..

Staff said the management was fair and approachable, care meetings were held every morning to discuss people’s changing needs and how staff would meet these. Staff meetings were held monthly and staff were able to contribute to the meetings and make suggestions. Relatives said the management was very good; the manager was always available, they would be happy to talk to them if they had any concerns and residents meetings provided an opportunity to discuss issues with other relatives and staff.

The provider had systems in place to review the support and care provided. A number of audits had been developed including those for care plans, medicines and health and safety. Maintenance records for equipment and the environment were up to date, such as fire safety equipment and hoists. Policies and procedures had been reviewed and updated and were available for staff to refer to as required. Staff said they were encouraged to suggest improvements to the service and relatives told us they could visit at any time and they were always made to feel welcome and involved in the care provided.

Inspection carried out on 29 October 2013

During a routine inspection

On the day of our visit we were met by the registered manager who was employed on an interim basis whilst a new permanent manager was being recruited. She told us that there were 72 people residing in the home out of a total capacity of 77. Later on we were joined by the business manager from the provider�s head office. Although there were a relatively large number of people living in the home we were unable to engage in conversation with most of them because of their level of need. However, we were able to have a long and in-depth conversation with a group of four people who used the service.

We found that people�s individual preferences and choices were being respected, and that there were a wide range of social activities for people to be involved in.

We found that, overall, people were satisfied with their level of care, and that the provider had an effective system in place for assessing, managing and reviewing people�s needs.

We found that staff were properly trained in safeguarding people from abuse and would be able to report any incidents of abuse without fear of recrimination from their employer.

We found that staff had received a full induction and training appropriate to their roles. We also found they received regular supervision and appraisal.

We found that the provider obtained regular feedback from people who used the service, relatives and staff. We also found they regularly assessed and monitored all aspects of the service.

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