Archived: Savile Park

Savile 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 this inspection. The home provides personal care for up to 55 older people, some of whom may be living with dementia. Accommodation is provided on three floors with passenger lift access between floors. There are communal areas on each floor, including a lounge and dining room. There were 55 people in the home when we inspected.

The home has a registered manager. 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.

At our last inspection on 3 October 2017 we rated the service as ‘Requires Improvement’. We identified two regulatory breaches (Regulations 11 and 17) which related to consent and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve all the key questions to at least good.

At this inspection we saw there had been improvements made in both areas and the service was compliant with all relevant health and social care regulations. The breaches we identified in October 2017 had been addressed and the rating for all key questions is now good.

Medicine management had improved which ensured people received their medicines when they needed them. People told us they felt safe in the home and praised the support they received from staff who they described as kind and caring. Staff knew how to recognise signs that people may be being abused and the procedures for reporting any concerns they had. Risks to people were well managed and care records guided staff in how to keep people safe. Accidents and incidents were monitored by the provider and lessons learned were shared with staff.

People told us the home was kept clean and we saw this was the case. Staff followed good infection control practices. Safety checks were in place to make sure the premises and equipment was properly maintained and safe.

Robust recruitment processes ensured staff were safe to work in the home. New staff completed a thorough induction process. Staff received the training and support they needed to carry out their roles and this was kept up to date. There were enough staff to meet people's needs.

People received personalised care which was reflected in their care records which were reviewed regularly. Staff were kept informed of any changes in people’s needs through good communication such as detailed handovers at staff shift changes. People’s healthcare needs were met. People enjoyed the food and were provided with a choice of meals and drinks to meet their needs and preferences.

Staff treated people with respect and maintained their privacy and dignity. Staff promoted people’s independence encouraging them to do as much as they could themselves. People had opportunities to take part in a range of different activities in the home and out in the community.

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 and relatives knew how to make a complaint and were confident it would be dealt with appropriately.

People, relatives and staff were unanimous in the praise about the management and leadership of the home. Effective quality audit systems were in place which helped the provider identify and address any issues in a timely way. Our discussions with the district manager and staff demonstrated the provider was committed to ongoing improvements and continually looking at ways in which they could improve the service for people coming in to Savile Park.

At our last inspection we rated the service as ‘good’ overall, and made a recommendation; ‘We recommend management continue to ensure improvements to the service continue and are sustained to ensure a consistent, high quality service.’ We did not identify any breaches of regulation. Since that inspection the provider (owner) of the home and management team had changed.

Savile Park is a care home with accommodation over three floors connected by lifts. Each floor has en suite rooms and living and dining areas. There are private gardens which can be accessed from the ground floor lounge and some people’s rooms. On the day of our inspection there were 54 people using the service, some of whom were living with dementia.

There was a registered manager in post on the day of our inspection. 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.

We identified some concerns in relation to the storage and administration of medicines. Some medicines were found unattended in people’s rooms, and there were not always guidelines in place to ensure people received ‘as and when’ medicines, for example for pain relief, appropriately. We found stocks of medicines matched records.

Risks associated with people’s care and support were documented, however we found the guidance for staff was not always sufficient to ensure these risks were fully minimised. The safety of the premises was well managed, however we identified malodours in some areas of the home.

Safeguarding was understood by staff who knew how to report any concerns. Accidents and incidents were well managed, with reports to the local authority and the Care Quality Commission being made as required.

Staff were recruited safely, although we found they were not always deployed in sufficient numbers. The registered manager had already identified this and we saw it was an item included in their action plan.

We found mental capacity and deprivation of liberty safeguards (DoLS) were not always fully understood or appropriately documented..

We saw there was a comprehensive training programme for staff, and people told us they had confidence in the abilities of the staff to provide effective care. People had timely access to health and social care professionals when this was needed. Staff had supervision and appraisal meetings to provide support, although feedback about the effectiveness of this was mixed.

People were positive about the food served at Savile Park, and we saw people received the support they needed. Kitchen staff had good knowledge about dietary requirements and ensured specialist dietary needs (for example for people who needed a soft diet) were well catered for. . There were snacks and drinks available at all times.

People told us the staff were caring and respectful of their privacy and dignity. Our observations highlighted inconsistencies in staff practice, however. We saw examples of good practice such as knocking on doors and speaking kindly with people. We also saw staff discuss people without consideration of their privacy and some delays in personal care being attended to. Care plans did not always contain sufficient detail about people’s preferences for care, although some people felt they had been consulted in the writing of their care plans.

Care plans were reviewed, however we found they were not always completed with sufficient or up to date information to ensure care was always responsive. Information about people’s interests was not always used in planning activities for them, and not all people were informed about what activities were taking place on the day of our inspection. There was a mix of feedback about the quality of activities in the home.

People felt confident in raising complaints or concerns, and we saw these were well managed. The registered manager invited people and their relatives to meetings to give feedback about the service.

We received positive feedback about the registered manager and the experience of living and working at Savile Park. There were processes in place to measure, monitor and improve the quality of the service, although we saw actions were not always completed in a timely way.

We identified two breaches of regulation during this inspection. You can see what action we have told the provider to take at the end of the full version of this report.

We also reviewed the information we held about the home before this inspection. This included information from the provider, and speaking with the local authority contracts and safeguarding teams.

On the day of our inspection we spoke with 21 people who lived at Savile Park, 11 members of staff, four relatives, the registered manager and the area manager.

We looked around some areas of the building including people's bedrooms and communal areas. We also spent time looking at records, which included six people's care records and records relating to the management of the home.

During our inspection we looked for the answers to five questions;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Is the service safe? The service was not safe. We found there were not always enough staff on duty to meet people's needs.

We found some practices in the home were depriving people of their liberty.

Is the service effective? The service was not always effective. Records showed people had regular access to healthcare professionals, such as GP's, district nurses, podiatrists and opticians. However, we found staff were not always following the advice that had been given.

Is the service caring? The service was caring. Staff knew about the lives, interests and preferences of people in their care. We saw staff treat people with patience, care and compassion.

Is the service responsive? The service was not responsive. Although complaints had been responded to, action had not been taken to stop the same problems arising again.

There were no activities on offer to keep people stimulated and occupied.

Is the service well-led? The service was not well led. The home did not have a detailed statement of purpose to give people information about the kinds of services provided and the range of people's needs which those services intended to meet.