19 November 2019
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.
The inspection team consisted of two inspectors on one day, an inspector and one specialist advisor for older person’s nursing care, and two experts by experience on another day, and a medicines inspector on another day. An expert by experience is a person who has personal experience of using services or cares for someone living with dementia/and or mental health needs. An inspection manager also attended to undertake an observed inspection of the inspector. The reason the inspection team was so large and the inspection was held over three days, was because of the specialism of the service, the layout of the building and the availability of inspection team.
Service and service type
Hartley Park Care Home 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We looked at statutory notifications the provider had made to us about important events. In addition, we reviewed all other information sent to us from members of the public and stakeholders, such as the local authority.
We also 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 contacted the local authority commissioning team and Healthwatch Plymouth for feedback about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch held no information about the service.
We used all of this information to plan our inspection.
During the inspection
The majority of people at the service are living with a dementia, which meant it was very difficult to obtain people’s views verbally. Therefore, we spent a considerable amount of time observing the interactions between people and staff. We also 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 in detail with six people, six relative’s, thirteen members of the care and domestic team, the chef, the deputy manager, the registered manager and provider.
We looked at 17 care plans for people who used the service, minutes of meetings, training records for all staff, various medicines administration records, and auditing and monitoring checks.
After the inspection
We continued to seek clarification from the manager to validate evidence found. We also contacted a dentist, and two mental health professionals for their views about the service.
19 November 2019
About the service
Hartley Park Care Home is a nursing and residential care home. It is registered to provide accommodation and personal care and accommodation for up to 66 older people. The service supports people living with dementia, a mental illness, and/or a physical disability. At the time of the inspection there were 61 people living at the service.
The service is on three floors, with access to upper floors via stairs or a shaft lift. All bedrooms have en-suite facilities. There is an outside garden area.
People’s experience of using this service and what we found
People lived in a service which had a strong, visible person-centred culture, with people and relatives, overwhelming telling us how wonderfully kind and compassionate the staff were.
People were at the heart of the service, and staff were motivated to deliver exceptional care by the provider’s imbedded values of ‘caring, compassion, courage, communication and confidence’. One member of staff told us, “We get so much enjoyment seeing the impact that we have on people's lives.”
People were supported by staff who truly cared about them and went the extra mile to make sure they felt loved and were happy. Respect for privacy and dignity was at the heart of the service’s culture and values. People and their representatives were regularly asked for their views about their care plans and the delivery of their service, and had their wishes respected.
The service had continued to go the extra mile to find out what people had done in the past and evaluated whether it could accommodate activities in line with their previous employment, interests and hobbies. The service understood the needs of people and delivered social activities in a way that met their needs and prompted equality.
The service had a key role in the community and was actively involved in building links. Staff made the special effort to ensure people were supported to avoid social isolation. Intergenerational care, the practice of bringing young and older people together, was seen as paramount importance.
Staff were exceptional at helping people to express their views, so they could understand people’s wishes and preferences. Staff used a variety of tools to communicate with people according to their needs, some of which included the use of technology.
People were actively involved in decisions about the staffing at the service by being involved in the recruitment process and/or by meeting potential new staff as part of the interview process. One person told us in doing so, they felt “valued and involved”.
There was a transparent and open culture that encouraged creative thinking in relation to people’s safely. The service actively sought out new technology and other solutions to make sure people lived with as few restrictions as possible, helping them to have an active and meaningful life.
People’s medicines were managed safely and in a pro-active way, with the use of medicines used in supporting people living with dementia only ever used as last resort.
The provider kept up to date with new research and developments to make sure staff were trained to follow best practice. The provider took a holistic approach to assessing, planning and delivering
people’s care and support, with people’s overall wellbeing considered an essential part of their care.
Staff were committed to working collaboratively and innovatively to deliver more joined up care and support to people. External professionals told us the service focused on providing person-centred care and support and achieved exceptional results.
People lived in a service which was clean and odour free and were empowered and encouraged to participate in the cleaning of the service, as they wanted to be.
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.
Staff were overwhelmingly complimentary of the training and support they received. The provider
looked at innovative ways to engage staff in training.
There was an exceptionally skilled and motivated registered manager in place, who role-modelled the ethos of the service. Staff were proud and motivated to work for the organisation.
The registered manager and provider were highly passionate about continuous development and improvement. There was a consistently high level of constructive engagement with staff and people to ensure outstanding practice was sustained overtime.
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 Outstanding (Published 10 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hartley Park Care Home on our website at www.cqc.org.uk.
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.