Park House Nursing Home

Park House Nursing Home is a residential care home providing accommodation for people who require nursing and personal care to up to 52 people. The service provides support to older people with physical health needs and people living with dementia. At the time of our inspection there were 47 people using the service.

People’s experience of the service and what we found:

People were protected from the risk of harm, they felt safe, and staff were aware of how to raise any safeguarding concerns. Care and risk support plans set out people's known risks and provided guidance to ensure staff could provide safe care. Medicines were managed safely. New staff were safely recruited and there were enough staff to meet people's needs.

Incidents and accidents were acted upon appropriately and lessons were learned when things went wrong. Mental capacity assessments were in place for people who lacked or had fluctuating capacity to make specific decisions. Staff supported people in the least restrictive way possible and in their best interests.

There was a positive culture in the service. People said the registered manager was approachable and responsive. Staff received regular supervision and one to one meetings, supporting learning and development. There was an ongoing improvement plan for the service. The provider ensured any lessons learned from incidents was shared across the service and the wider organisation.

People were treated with respect and their dignity was upheld. We observed staff interacting with people in a friendly and supportive way. There was a positive approach to the delivery of people's care. Staff understood the people they were supporting and knew them well.

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 02 October 2018)

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding people. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Recommendations

We have made a recommendation around engagement opportunities. Please see the responsive section of this report.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Park House Nursing Home is a nursing and residential care home providing personal and nursing care to 48 people aged 65 and over at the time of the inspection. The service can support up to 52 people.

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

We received positive feedback about the service provided from people and staff. One person said, “Staff make sure I have all I need, I love living here.” Another person said, “I have everything I need. The staff always come when I call. I couldn’t ask for better care.”

We observed kind and caring interactions between staff and the people who lived at the service. Staff told us they felt there was enough staff and they were visible around the service and were readily available to support people when needed.

Staff understood the identified risks to people and followed guidance in place to keep them safe.

The service was clean and well maintained. Infection control arrangements were in place to prevent and mitigate the risk of COVID-19. Appropriate protective and personal equipment (PPE) was in place and care staff used this appropriately.

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 2 October 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and a risk to people needs not being met. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.

We found the following examples of good practice.

Staff made sure that people were protected against the transmission of infection from visitors by scheduling visits, limiting areas that visitors could access and being available to escort visitors.

Staff made sure there were measures in place to protect people admitted to and people living at the service from the spread of infection.

Staff wore personal protective equipment, such as masks, gloves and aprons, and had supported people so that they also understood the need for this.

Whole home testing was carried out and the provider kept other information, such as how staff were feeling after their isolation period had ended, to make sure that staff were safe to return to work.

The provider made sure staff and the registered manager received enough support during the pandemic and when additional staff were needed.

Staff had increased cleaning of frequently touched surfaces to reduce the risk of transmission of infection.

Policies in place had been updated with COVID-19 information, which meant that actions to reduce the risk of transmission were taken.

Park House Nursing Home provides, accommodation, nursing and personal care for up to 52 people; some of whom are living with dementia. It is also registered to provide the regulated activity; treatment, disease, disorder and injury. At the time of this inspection there were 47 people living in the service.

At the last inspection on 19 July 2017, the service was rated 'requires improvement' in the areas of safe and well led. At this inspection, we found the service had made improvements under the questions is the service safe and well-led? The service is now rated as good.

Park House Nursing 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.

There was a registered manager in post at the time of this inspection. 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.

Care plans did not all provide detailed guidance to staff to ensure that people were receiving the appropriate care at all times. People felt safe and staff knew how to respond to possible harm and how to reduce risks to people. People were looked after by enough staff, who were trained and supervised to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service.

Lessons were learnt about accidents and incidents and these were shared with staff members to ensure changes were made to staff practices and to reduce further occurrences.

People’s medication was well managed by staff that had received training and have been assessed as competent.

People were looked after by enough staff, who were trained and supervised to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service.

People’s privacy and dignity was promoted and maintained by staff. People received a caring service as their needs were met in a considerate manner and staff knew the people they cared for well. People were involved in their care and staff encouraged people’s independence as far as practicable. Activities were offered to support people’s interests and well-being. Equipment and technology was used to assist people to receive care and support which included the use of call bells.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s confidential records were held securely.

Systems were in place to promote and maintain good infection prevention and control.

People received a choice of meals, which they liked, and staff supported them to eat and drink. People were referred to health care professionals as needed and staff followed their advice. The registered manager and staff team worked with other health and social care organisations to make sure that people's care was coordinated and person centred.

Compliments were received about the service and complaints investigated, responded to and resolved where possible to the complainants’ satisfaction. Staff worked well with other external health professionals to make sure that peoples end-of-life care was well managed and this helped ensure people could have a dignified death.

Quality monitoring procedures were in place and action was taken where improvements were identified. There were clear management arrangements in place. Staff, people and their relatives were able to make suggestions and actions were taken as a result.

Further information is in the detailed findings below.

This comprehensive inspection took place on 19 July 2017 and was unannounced.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager was present during this inspection.

Risks to people who lived at the home had been identified and staff were aware how to reduce risks to people. However, the systems in place to manage or minimise the risks to people had not always been used. Audits in relation to care plans, risk assessments and fluid charts had not always identified all areas of improvement required.

People had their medication administered as prescribed. The provider's policy on administration and recording of medication had been followed by staff. Internal and external audits in relation to medication administration had been completed and were robust.

People had their needs assessed and reviewed. Staff knew how to support people and meet their requirements even though information had not always been recorded in people’s care plans. People's care plans contained person centred information which detailed people’s likes and dislikes and how they wished to be supported.

There was a system in place to record complaints. These records included the outcomes of complaints, that people were satisfied with the outcomes and how the information was to be used by staff to reduce the risk of recurrence.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and could describe how people were supported to make decisions. Training had been provided by the provider and staff were aware of current information and regulations regarding people’s consent to care. This meant that there was a reduced risk that any decisions, made on people's behalf by staff, would not be in their best interest and as least restrictive as possible.

People were kept safe because there were sufficient numbers of staff to meet people’s needs. The provider had a recruitment process in place and staff were only employed within the home after all essential safety checks had been satisfactorily completed. Staff received an induction when they started work and further training was available for all staff which provided them with the skills they needed to meet people’s requirements.

People and/or their relatives were involved in how their care and support was provided. Staff treated people with care and respect and made sure that their privacy and dignity was respected all of the time. Staff monitored people’s health and welfare needs and acted on issues identified. People were enabled to access health care professionals when they needed them. People were provided with a choice of food and drink that they enjoyed. People, where required, were given the right amount of support from staff to enable them to eat and drink.

People, relatives and staff were able to provide feedback and information. There were systems in place to monitor and audit the quality of the home.

Staff meetings, supervision and individual staff appraisals were completed regularly. Staff were supported by the registered manager and deputy manager during the day. A management out of hours on call system was in place to support staff, when required.

You can see what action we told the provider to take at the back of the full version of the report.