Archived: South Park Care Home

South Park Care Home provides accommodation, nursing and personal care for up to 80

People across two separate wings. One of the wings specialises in providing care to people living with dementia. At the time of the inspection, there were 70 people living in the home.

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

Staff kept people safe from risk of abuse and avoidable harm. There were systems in place to respond quickly to accidents and incidents and lessons were learnt when things went wrong. People told us they received their medicines as prescribed.

People’s needs were thoroughly assessed, and staff made prompt referrals to external agencies when people’s needs changed. They applied their knowledge and skills to achieve good outcomes for people.

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.

The home was warm and welcoming. People benefited from a range of facilities, including a mock pub, café and cinema room.

Staff were kind and compassionate and demonstrated a genuine desire to provide high-quality, person-centred care. People and relatives were united in their positive feedback about the caring nature of staff.

There was a robust governance frame work in place and clear lines of accountability.

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

Rating at last inspection

The last rating for this service was good (published 4 April October 2017).

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.

At our last inspection on 13 and 14 January 2016 we rated the service as Requires Improvement. Although the service was compliant with the Health and Social Care Act 2008 (Regulated Activity) Regulations 2014 we did not revise the rating for the service to ‘Good’ as the service had previously been in ‘special measures’. There was a need for the service to be able to demonstrate a longer term track record of consistent good practice.

We found that the registered provider had continued to make improvements to the service in-line with the fundamental standards over the past year. They were able to demonstrate to us at this inspection that sustained improvements had been made and this is reflected in the overall rating of 'Good', which has now been achieved.

South Park Care Home is a purpose built service registered to provide nursing care for older people. There are two separate units or ‘households’ as the service prefers to call them. Ebor accommodates up to 44 people with mental health and/or dementia care needs on two floors. Jorvik accommodates up to 36 people with general nursing needs over three floors. The service is situated in a residential area to the west of the city centre, and on a bus route to the city. There are parking facilities on site and local shops and other amenities close by.

At the time of this inspection there were 59 people using the service, 37 on Ebor and 22 on Jorvik.

People told us they felt safe and were well cared for. The registered provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed to assist people in a timely way. People’s medicines were managed safely.

People that used the service were supported by qualified and competent staff that were regularly supervised and received appraisal regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include people's preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

Staff were knowledgeable about people’s individual care needs and care plans were person centred and detailed. There was a range of social activities available and people’s spiritual needs were met through in-house services and one-to-one pastoral care when requested.

People told us that the service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People and staff were asked for their views and their suggestions were used to continuously improve the service.

The last inspection took place on 13 and 14 August 2015. At that inspection we asked the registered provider to take action to make improvements to Regulation 18: Staffing; Regulation 12: Safe care and treatment; Regulation 14: Meeting nutritional and hydration needs; Regulation 9: Person centred care; Regulation 15: Premises and Equipment; Regulation 17: Good Governance. These actions have now been completed. After the comprehensive inspection on 13 and 14 August 2015 the registered provider wrote to us to say what they would do to meet the legal requirement in relation to the breaches of regulation.

South Park Care Home is a purpose built home registered to provide nursing care for older people. There are two separate units. Ebor unit accommodates up to 44 people with mental health and/or dementia care needs on two floors. Jorvik unit accommodates up to 36 people with general nursing needs. Jorvik unit has three floors, with most of the communal areas on the ground floor. The unit does have an additional communal lounge on the third floor.

The two units have their own staff teams and each has a ‘Head of Unit’, responsible for the day to day running of the unit. There are lifts on each unit. People living downstairs on Ebor unit have access to a safe garden area. People living upstairs on Ebor unit typically require more personal care and support than those living downstairs. The service is situated in a residential area to the west of York city centre and on a bus route to the city. There are parking facilities on site and local shops and other amenities close by.

At the time of this inspection there were a total of 48 people using the service. On Ebor unit there were 31 people with mental health conditions and/or dementia care needs and Jorvik unit supported 17 people with general nursing needs. At the time of this inspection there was refurbishment work on-going on Jorvik unit so the top floor had been closed and people had moved down into accommodation on the first floor of the unit.

There has not been a registered manager at this service since December 2013. A new manager was appointed in November 2015 and they submitted an application to register with the Care Quality Commission in December 2015. 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 told us that they felt safe living at the home. We found that staff had a good knowledge of how to keep people safe from harm and staff had been employed following robust recruitment and selection processes.

Improvements had been made to the number of staff employed in the service. Recruitment was on-going to ensure enough staff were employed to meet the needs of people who used the service. Sufficient permanent staff had been recruited since our last inspection to ensure the use of agency staff had been reduced to a minimum. Staff did not appear rushed on the two days of our inspection and there was a good atmosphere in the service.

Improvements had been made to the medicine practices in the service. Medicines were administered safely by staff and the arrangements for ordering, storage, administration and recording were robust. However, we did note that the nursing staff continued to be interrupted by other staff and visiting professionals during the medicine rounds.

Improvements were made to the control and prevention of infections systems within the service and we found the service to be clean and hygienic. The registered provider had introduced mattress audits, steam cleaning of furniture, plastic tubing on light cords, purchased new quilts and pillows and new bed linen as some of the activities to address the infection prevention and control concerns from the last inspection.

Improvements had been made to staff training and supervision. The registered provider had an induction and training programme in place and staff were receiving regular supervision. Staff told us they still had problems accessing the on line training courses, but people using the service felt more confident in the staff skills and knowledge and said the reduction in agency staff meant they were receiving better care and support.

Improvements had been made to the dining experience of people living in the service. We saw that appropriate support with eating and drinking was provided to people who used the service and we saw that people received good quality meals and plentiful drinks throughout the day.

Improvements had been made to the way staff communicated with each other and with people and relatives. People felt more included in decisions about their care and we saw that appropriate care and support was being offered to people who used the service. We observed a number of positive interactions between the staff and people they were caring for. We were told by people and relatives that oral hygiene care, pressure care and contact with external health care professionals was much better.

Improvements had been made to the safety of the premises and the overall look and style of the environment. The registered provider had made significant investment in refurbishing and redecorating bathrooms, shower rooms, bedrooms and communal areas throughout the home. The updating of the environment continued at the time of our inspection and people were living in a pleasant and comfortable home.

Improvements had been made to the way that care and treatment of people who used the service was provided. We saw that staff were more attentive and people received appropriate care and support in accordance with their wishes. Calls for assistance were answered in a timely manner and staff were visible on the units and seen attending to people’s needs.

Improvements to staff practice had been made to ensure that people were treated with respect and dignity by the staff. There was a formal complaints system in place to manage complaints if or when they were received. There was one complaint being investigated by the registered provider at the time of our inspection.

Improvements to the recording and documentation of care had been made. The registered provider had introduced a new format for the care plans and this was in place at the time of our inspection; although some of the documentation was still being transferred over. The new paperwork was well organised, detailed and person centred and systems were in place for monthly reviews of the care files. However, some of the staff were uncertain where to find some of the information we asked for although they were eventually able to locate it and show it to us. We noted that staff were able to tell us about people’s care needs and demonstrated an improved knowledge of their health care conditions.

Improvements had been made to the quality assurance system including the safety of the service, the risks relating to the health, safety and welfare of people who used the service and the way feedback from people who used the service and staff was obtained. The manager monitored the quality of the service, supported the staff team and ensured that people who used the service were able to make suggestions and raise concerns. We received positive feedback from people who used the service, visitors, relatives and staff about the changes taking place in the service.

We spoke to people who use the service and their relatives. Comments included: “They are very kind to me and we often have a good laugh.”, “These carers are smashing!” And “It has got better as they have a new manager now.”

People were involved in making decisions about how their care and support was delivered and where people lacked capacity their rights were respected and the provider acted in accordance with legal requirements.

People had care plans and risk assessments in place which helped staff to understand and meet people's needs.

People were provided with a choice of suitable and nutritious food and drink.

The provider had clear systems in place for supporting people with medication and staff were trained in the safe handling of medicines.

There were sufficient care staff available for the number of people living at the home. We saw people being assisted promptly and staff had time to spend with people.

The provider had an effective system in place to regularly assess and monitor the quality of service that people received.

The home had a high level of staff vacancies this meant that approximately 60% of the current staff were provided by an agency or the provider's own staff were completing overtime. We found that this had a major impact on the consistency and quality of care and support people received.

People told us that care was improving and some of the staff were excellent. Others expressed concern and did not feel confident that the care they were receiving was good enough.

We saw staff responding to people in a kind and patient manner but we also saw some circumstances which demonstrated a lack of respect for people's privacy and dignity.

Some people had consented to their care and treatment. However, on Ebor unit, we saw few attempts to offer people choice about the care and support they experienced.

Some people were not given a choice of meal and were not supported with dignity.

Recording and administering of medication were unsafe which meant people were at risk of not receiving their medication as prescribed.

Information contained in people's care records was inconsistent; which increased the risk for people not receiving care according to their needs and wishes.

Poor auditing and record keeping meant that people's health and safety was being placed at unnecessary risk of harm.

People said they were well cared for and liked living at the home. One person said "I am warm and comfortable. If I need the doctor the staff sort it out for me. I have no health worries; I am very well at the moment."

The home had systems in place to help safeguard people and people told us they felt safe. All of the people we spoke to said that they felt able to talk to the staff about anything that concerned them.

Some areas of the home were shabby and in need of refurbishment. The manager confirmed that some refurbishment work is planned for the New Year. This included to improve and extend the communal living space in the ground floor dementia care unit. Some bedrooms were also going to be refurbished and redecorated.

Staff told us they received regular training to help keep their knowledge and skills up to date. They also told us that supervision was now being provided for them on a more regular basis.

All of the people we spoke with said that they would feel confident in raising any concerns. They told us that staff were friendly and approachable.