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Inspection carried out on 22 February 2017

During a routine inspection

The inspection took place on 22 and 23 February 2017. The first day of the inspection was unannounced. Hartley Park Care Home provides residential and nursing care for people who may have mental health needs and living with dementia. Hartley Park Care home provides care and accommodation for up to 66 people. On the day of the inspection 66 people lived in the home. The service is owned by Abholly (2008) Ltd.

At the last inspection on 6 August 2014, the service was rated Outstanding in Effective and Well-Led. During this inspection, following feedback from staff and the inspection, the provider was making further improvements to the induction to ensure all staff felt supported and prepared to work at Hartley Park Care. We also inspected the service during a special, Chinese lunchtime meal which meant the mealtime experience was less planned and organised than our last inspection. These affected the rating previously obtained in this area. At this inspection we found the service was Outstanding in Caring, Responsive and Well-Led.

Why the service is rated outstanding:

The service had 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.

People, relatives and professionals told us all aspects of the service were excellent. People and relatives consistently told us they felt cared for, valued, and listened to and that their views mattered. There was a strong commitment to developing respectful, trusting relationships. Staff all demonstrated compassion and empathy. People’s care was based upon best practice and constantly reviewed. Care was planned around people and their preferences including their religious or cultural wishes. People were at the heart of care.

People receiving end of life care were treated compassionately, as were relatives.

Relatives advised us they could visit at any time and felt a part of a family. They described the service and support they received in exceptional terms.

The kitchen staff were passionate about their role to ensure people ate well to maintain and improve their health. People repeatedly commented on the “amazing, home cooked” food. Mealtimes were a positive, social experience. People told us meals were of excellent quality and quantity and there were always alternatives on offer for them to choose from. People were involved in planning the menus and their feedback on the food was sought.

People had their healthcare needs met. Staff quickly noticed when people’s health changed and were thoughtful, proactive and reflective as to why this might be, considering people’s physical health and social needs. People were supported to see a range of health and social care professionals including social workers, chiropodists, district nurses and doctors. Feedback from professionals was outstanding.

The atmosphere in the home was calm and we observed people taking part in the activities. There was a special Chinese food day during the inspection with people enjoying trying a spring roll and using chopsticks. Activities were plentiful and meaningful enabling people to live as full a life as possible. A range of group and one to one opportunities were available for those who liked to participate. People and relatives appreciated the activities co-ordinator.

There was a positive culture within the service. The management team had a clear vision about how they wished the service to be provided. Values were shared by the whole staff team. Staff talked about ‘personalised care’ and ‘respecting people’s choices’ and had a clear aim about improving people’s lives and opportunities.

There was a management structure in the service which provided clear lines of responsibility and accountability. A registered manager was in post that had overall responsibility for the service. They were supported by the providers, unit managers and other senior staff who had designated management responsibilities. People told us they knew who to speak to in the office and any changes or concerns were dealt with swiftly and efficiently.

Feedback received by the service and outcomes from audits were used to aid learning and drive improvement across the service. The registered manager and staff monitored the quality of the service by regularly undertaking a range of audits and speaking with people to ensure they were happy with the service they received. People and their relatives told us the management team were fantastic, approachable and included them in discussions about their care and the running of the service. Hartley Park was described by many relatives as “A five star home”.

People told us they felt confident, safe and secure using the service. People were comfortable approaching staff. There were risk assessments in place to help reduce any risks related to people’s care and support needs. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected.

People were kept safe by suitable staffing levels which were adjusted when required, to meet people’s needs. Relatives told us there were enough staff on duty and we observed unhurried interactions between people and staff. This meant that people’s needs were met in a timely manner. Recruitment practices were safe. Checks were carried out prior to staff commencing their employment to ensure they had the correct characteristics and values to work with vulnerable people.

People’s medicines were given safely. Staff were patient and encouraging as they supported people to take their medicines. Robust checks were in place to ensure people had the right medicine at the right time.

Staff had received an induction when they commenced work training relevant to their role. There was a thorough system in place to continue to enhance staff skills and knowledge to support quality care. Staff received excellent support and supervision in their roles to help ensure the values and expectations of care delivery were understood.

People received support from staff who had an in depth knowledge of them and went the extra mile to get to know them. Research based initiatives such as all staff spending five minutes a day with people built upon this. People, relatives and healthcare professionals spoke very highly of the staff and the support provided.

The registered manager and staff had attended training on the Mental Capacity Act 2005 (MCA).

Staff were knowledgeable about the Mental Capacity Act and how this applied to their role. Where people lacked the capacity to make decisions for themselves, processes ensured that their rights were protected. Where people’s liberty was restricted in their best interests, the correct legal procedures had been followed. People were involved in planning their care and staff sought their consent prior to providing them with assistance. Staff advocated for people to ensure they received the best possible outcomes.

Inspection carried out on 6 August 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC) which looks at the overall quality of the service.

Hartley Park Care Home is a purpose built nursing home providing residential and nursing care for up to 66 people. On the day of our inspection 66 people were living at the home. Hartley Park specialises in care for older people who have mental health needs including people living with dementia. The home has a registered manager in place. 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 and associated regulations about how the service is run.

On the day of our inspection there was a calm, friendly and homely atmosphere. People appeared relaxed and happy. People, their relatives and health care professionals all spoke highly about the care and support Hartley Park provided. One person said; “I am very happy here, it’s just lovely.” A relative told us; “Staff are always friendly, the care is so good, nothing is too much trouble.” An independent mental capacity advisor (IMCA), commented

; “Staff support people in the best way they can.”

The environment encouraged people to be independent and promoted people’s freedom. The design and décor of the building had been carefully thought out and took account of people’s needs. P

eople who were able moved freely around the building and its grounds as they chose

. People were involved in decisions about proposed changes to further enhance their day to day lives.

Information we requested was supplied promptly. Care records were comprehensive and written to a high standard. They contained detailed personalised information about how individuals wished to be supported. People’s preferred method of communication was taken into account and respected. People’s risks were well managed, monitored and regularly reviewed to help keep people safe. People had choice and control over their lives and were supported to take part in a varied range of activities both inside the home and outside in the community. Activities were meaningful and reflected people’s interests and hobbies.

Staff put people at the heart of their work, they exhibited a kind and compassionate attitude towards people. Strong relationships had been developed. Staff focused on the person and not the task in hand. Staff were highly motivated, creative in finding innovative ways to overcome obstacles that restricted people’s independence and had an in-depth appreciation of how to respect people’s individual needs around their privacy and dignity.

The service had an excellent understanding of people social and cultural needs and how this may affect the way they want to receive care. Staff planned support in partnership with people and used personalised ways to involve people to achieve this and help ensure people felt valued. Innovative ways were used to help enable people to live as full a life as possible and enhance people’s wellbeing.   

Relatives and friends were always welcomed and people were supported to maintain relationships with those who matter to them. Staff were well supported through induction and on-going training. Staff were encouraged to enhance their skills and professional development was promoted. A staff member said; “Training is so good, we are supported to provide a high standard of care to people.”

Staff understood their role with regards the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS).

All staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated. People told us they felt safe.

People knew how to raise concerns and make complaints. People told us concerns raised had been dealt with promptly and satisfactorily. Any complaints made were thoroughly investigated and recorded in line with Hartley Park’s own policy. Learning from incidents had occurred and been used to drive improvements.

Staff described the management as very supportive and approachable. Staff talked positively about their jobs. Comments included: “It’s such a great place to work, I enjoy it so much, it’s all so friendly, everybody gets along” and “The manager is part of what makes working here so good, so supportive and kind, I love my job.”

There was strong leadership which put people first. The service had an open culture with a clear vision. The registered manager had set values that were respected and adhered to by all staff. Staff were encouraged to come up with innovative ways to improve the quality of care people received. Staff felt listened to and empowered to communicate ways they felt the service could raise its standards and were confident to challenge practice when they felt more appropriate methods could be used to drive quality.

People’s opinions were sought and there were effective quality assurance systems that monitored people’s satisfaction with the service. Timely audits were carried out and investigations following incidents and accidents were used to help make improvements and ensure positive progress was made in the delivery of care and support provided by the home.

Inspection carried out on 25 April 2013

During a routine inspection

We spoke with many people who lived at Hartley Park. Those who were able to communicate with us spoke warmly of the home and staff. Those who were unwell and who were unable to talk to us looked peaceful, comfortable and relaxed.

People told us, "It's easy going here." "I'm very well looked after." The relatives we met spoke of the home with high regard, "we laugh and joke together, staff are brilliant."

We found people were cared for well. People were involved in discussions about their care and treatment, treated kindly and with respect.

We found the staff to be enthusiastic about their work and keen to provide the best quality of care they could. They were skilled and competent and they felt supported by the registered manager and the owners.

The staff understood how to safeguard and protect vulnerable people. They also understood their roles and responsibilities under the Mental Capacity Act (2005) and they were confident following national and local guidance when considering people's capacity.