Park Lodge

Park Lodge operates a care home and a domiciliary care service.

The care home provides personal and nursing care mainly to people aged 65 and over. The care home can accommodate up to 40 people, at the time of our inspection there were 37 people using the service.

The domiciliary care agency provides personal care to people living in their own houses and flats in the community. At the time of our inspection the domiciliary care service was supporting 10 people with personal care.

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

People told us the service was safe and there were enough staff to meet their needs. People were confident the staff team had the right skills and knowledge to meet their needs. Staff received regular training and told us they felt supported in their roles.

People told us, and we observed staff were kind and caring. People’s privacy and dignity were respected, and people were supported to be as independent as possible.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to share their views of the service. People were given feedback on the actions taken in response to their comments.

Risks to people’s safety and welfare were identified and managed. Staff were safely recruited. People's medicines were managed safely. The home was clean and there were systems in place to prevent and control infection. Equipment and installations were maintained.

Feedback about the food was good. People’s dietary needs and preferences were catered for and people’s oral health care was considered.

People’s needs were assessed, and their care records had improved to ensure staff had clear information about people’s current needs.

Improvements had been made to the systems and processes in place to monitor the safety and quality of the service. There was a positive, open and supportive culture at the service.

The service worked with external professionals for the benefit of people who used the service.

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

Rating at last inspection and update: The last rating for this service was requires improvement (published 14 November 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

Park Lodge operates both a care home and domiciliary care service under the registration of this location with the Care Quality Commission (CQC). The care home provides accommodation for persons who require nursing or personal care for up to 40, primarily, older people. The domiciliary care service offers care to people in their own homes. At the time of our inspection, 38 people were using the care home service and 13 were using the domiciliary care service.

Park Lodge 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.

This service is also a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

Park Lodge was last inspected on 10 November 2015 and the service was rated as Good. On this inspection, the service has been rated as Requires Improvement. Providers should be aiming to achieve and sustain a rating of 'Good' or 'Outstanding'. Good care is the minimum that people receiving services should expect and deserve to receive; we found systems in place to ensure improvements were made and sustained were not effective. This is the first time the service has been rated Requires Improvement.

There was a registered manager in post. A registered manager is a person who has registered with 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.

There were systems in place to monitor and improve the quality of the service provided. However, these were not fully effective and had failed to identify the concerns we found with regards to several records in the service.

We found some care plans lacked person-centred detail and contained inconsistent or contradictory information. This could lead to people’s care needs being missed or overlooked.

We identified some improvements were needed to the records of medicines administration. The registered manager acted to ensure the concerns were addressed by the end of the inspection.

Overall, we saw risks were managed, and staff understood how to ensure these risks were minimised. However, records of risk management needed to be strengthened.

The registered manager and staff we spoke with had some understanding of the principles of the Mental Capacity Act (MCA) 2005 and their responsibilities when working in accordance with the legislation. However, where people lacked capacity to make decisions about aspects of their care, records did not show how decisions had been made in people’s best interests.

We recommend the provider reviews the records of capacity assessments and decisions made in people’s best interests to ensure people’s rights are fully upheld.

Staff were seen to be kind and caring in their interactions with people, but some people told us they did not always find all staff to be caring in their approach. Staff showed a good knowledge of the people they supported, and understood how to maintain their privacy and dignity.

People and staff told us the service was safe. Staff could tell us how they would report and recognise signs of abuse and had received training in safeguarding adults. Recruitment was managed safely.

There were enough staff to provide support and ensure people’s needs were met. Staff received supervision, appraisal and training to enable them to carry out their role. Staff spoke highly of the support and training they received.

People received support from health care professionals where they needed this to keep well. People spoke highly of the food at the service and their dietary needs were recognised and met.

There were effective systems in place for responding to people’s concerns and complaints. People told us they knew how to raise concerns if they had any.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.

We observed the interaction between staff and people living at the home. We saw that people received the care they needed when they needed it and that staff understood the person's needs and how they should be cared for. People were spoken to kindly and responded cheerfully to staff. We saw that no person was ill at ease and people appeared to be relaxed and engaged in their chosen activity. There were enough staff on duty to meet people's needs in a timely way. Staff were unhurried and gave people plenty of time to respond. Staff showed that they understood the needs of people.

We found that the staff we spoke with were appropriately qualified which enabled them to do their job. One staff member said "I like to keep refreshed with training and the organisation supports me to do that."

We saw a copy of the home's complaint procedure displayed by the lift in the entrance hall.

People had thorough, detailed care plans relating to all aspects of their care needs. They contained a good level of information setting out exactly how each person should be supported to ensure that their needs were met. We spoke with five people and they told us they were happy with the care and treatment they received. One person told us, 'I get value for money, I can't grumble, I am quite happy here.' Another person said, 'I'm fine, I am happy here.'

We observed that people were cared for in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection. The people we spoke with told us that they had no concerns with the cleanliness of the home.

We found that people were supported by sufficient numbers of qualified, skilled and experienced staff which met people's needs. People we spoke with told us there were always enough staff to help them when they needed support.

Complaints people made were responded to appropriately. People told us if they had any concerns or complaints they would discuss them with the manager or members of staff and they were confident of using the complaints system.