Archived: Paradise House

Updated 16 November 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was conducted by two inspectors, one medicines specialist and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Paradise House 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Our planning took into account information we held about the service including information submitted by the registered manager about accidents and incidents, deaths and safeguarding incidents. We also looked at information shared by the local safeguarding authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with four people and three relatives. Not all of those who lived at the service were able to communicate with us. Therefore, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the provider, registered manager and regional manager. We also spoke with five members of staff. We looked at four staff recruitment and training files, four people’s care records and multiple records relating to the management of people’s medicines, staffing, quality assurance and governance. We spoke to two visiting professionals.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at records relating to the management of people’s records.

Updated 16 November 2019

About the service

Paradise House is a residential care home providing personal care to 37 people who lived with dementia at the time of the inspection. The service can support up to 39 people in one adapted building.

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

Since the last inspection there had been significant improvements. At the time of the inspection people were no longer at risk of avoidable harm and the service was managed in an effective way.

The provider had recruited a new registered manager and a new regional manager. The senior management team had addressed the failings outlined at the last inspection (January 2019) and sustained improvements made.

People received safe care and treatment. Accidents and incidents were analysed, and lessons learnt recorded. Staff supported people with positive risk taking.

There had been some improvement in the way people’s medicines were managed for example; ordering and receiving of medicines. However, we found some areas of medicines management still needed improvement. We did not find any evidence of actual harm caused and the provider acted on our concerns immediately. We were reassured by the action taken and therefore we have made a recommendation about the management of medicines.

People’s relatives said staff had sufficient training and were competent to undertake their role and responsibilities. Staff told us they received a good standard of training and felt supported. People received good nutrition and were encouraged to remain independent at meal times.

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. We made a recommendation about the recording of mental capacity assessments.

Staff supported people in a kind, respectful and dignified way. Staff had built trusting relationships with people and understood their needs and preferences. The provider had procedures in place to promote equality and diversity. There was an inclusive culture and staff understood the importance of working in a non-discriminative way.

People received person-centred care and care plans contained information about their needs and preferences. Staff were responsive to people’s changing needs. Staff responded in a person-centred way when people were distressed.

We found staff sometimes did not acknowledge when people were disengaged. The registered manager assured us they would work with staff to improve understanding of people’s non-verbal behaviours and how to stimulate people living with dementia to improve their quality of life.

People were supported in a person-centred way when at the end of their life. The registered manager had started to improve the way people’s end of life wishes were discussed, including their preferred place of care to die.

There had been significant improvement in the way the service was led. Staff, relatives and visiting professionals told us the registered manager had created a positive culture. There were improved systems in place to assess, monitor and evaluate 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 inadequate (published 12 July 2019) and there were multiple breaches 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.

This service has been in Special Measures since July 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Paradise House on our website at www.cqc.org.uk.

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.