Frenchay Park Gardens is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Frenchay Park Gardens provides accommodation with nursing and personal care for up to 30 people. At the time of our inspection 18 people were living in the home.

At the last inspection in October 2015, the service was rated Good. We carried out a comprehensive inspection on 23 January 2018. At this inspection we found, overall, the service remained Good.

There was 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.

Sufficient numbers of staff were deployed at the time of our visit. Staff performance was effectively monitored. Staff received supervision and training to ensure they could meet people’s needs.

People’s medicines were managed safely and audits and checks were completed. Actions were taken when errors were identified.

Staff demonstrated a good understanding of safeguarding and whistleblowing and knew how to report concerns.

Risk assessments and risk management plans were in place. Improvements were needed to make sure risk management plans were followed. We have made a recommendation that further guidance is sought with regard to infection control practices in the home.

Incidents and accidents were recorded and the records showed that actions were taken to minimise the risk of recurrences.

People’s dietary requirements and preferences were recorded and people were provided with choices at mealtimes.

Staff were kind and caring. We found people were being treated with dignity and respect and people’s privacy was maintained.

Systems were in place for monitoring quality and safety and actions were taken where areas for improvement and shortfalls had been identified.

We carried out this inspection on 20 October 2015 and this was an unannounced inspection. During a previous inspection of this service in July 2014 there were no breaches of the legal requirements identified.

Frenchay Park Nursing Home is registered to provide personal and nursing care for a maximum of 30 people. At the time of the inspection there were 24 people living in the home. The home provides care to people living with dementia.

A registered manager was in post at the time of our 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 and associated Regulations about how the service is run.

People and their relatives felt the service was safe. The service ensured there were sufficient staff on duty to meet people’s assessed needs and safe recruitment procedures were completed.

People’s received the support they required with their medicines. Medicines were managed safely.

A regular review of incidents and accidents was completed. The purpose of the review was to prevent or reduce reoccurrence through intervention and support for people.

Staff received training in safeguarding adults and were aware of the reporting procedures should they have any concerns. An assessment of people’s risks was completed and supporting risk management guidance was recorded where required. The environment and the equipment used to support people was regularly assessed and serviced to ensure it was safe.

People and their relatives said the staff at the home provided effective care. The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the mental capacity to consent to treatment or care and need protecting from harm. At the time of our inspection, eight people had a DoLS authorisation in place.

Staff were aware of how the Mental Capacity Act 2005 impacted on their work and demonstrated how they empowered people through choice. Staff said they received regular training and this enabled them to meet the needs of people at the home. Staff were also supported through performance supervision and received an annual appraisal.

People at the service were supported as required to eat and drink and people had access to healthcare professionals when needed.

People and their relatives gave positive feedback about the care they received and the staff at the home. Staff we spoke with knew people well and people were relaxed in the company of staff. We observed that people’s privacy and dignity was respected and people’s visitors were welcomed to the service. The services compliments log also contained similar positive information about the level of care.

The service was responsive to people’s needs. Care records contained personalised information and care was delivered in line with people’s needs. There were activities for people to partake in and people spoke positively about the activities provided and the activities co-ordinator. The views of people and their relatives were sought and there was a complaints process which people and their relatives felt they could use.

The registered manager was highly spoken of by people, their relatives and the staff. Staff felt supported in their roles and the management had sufficient systems to communicate with the staff.

The registered manager had systems to monitor the quality of care provided and auditing systems to monitor records and documentation used by staff.

A single inspector carried out this inspection and spoke with two people who use the service, two visitors, the registered manager, the group manager, one nurse, one carer, the activities co-ordinator and the maintenance man. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People were cared for in an environment that was safe and clean. The provider had identified prior to our inspection that some flooring needed to be replaced in two rooms. We were informed that this had been actioned by both the manager and the group manager. There were enough staff on duty to meet the needs of people that lived at Frenchay Park. We reviewed the training records and the training plans for staff. From evidence that we saw and from speaking with the staff we found staff had received training in order to perform their roles safely. One person told us "I feel very safe here".

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. During our inspection we saw evidence that people had been assessed in accordance with these safeguards in line with procedures and we found the provider was compliant. The manager demonstrated an in-depth knowledge of the safeguards which showed us they understood their responsibilities to the people who used the service.

Is the service effective?

It was clear from what we observed and from speaking with staff that they understood people's care and support needs. The care plans we saw were up to date and contained information tailored towards people's individual needs. One person told us "all of the staff are very nice" and one visitor told us "I would recommend this place to anyone".

Is the service caring?

All of the staff that we spoke with and observed were kind and attentive to people's needs. One staff member told us "the team provide wonderful care and attention" and another told us "it's homely here, rather than institutionalised". One person who used the service told us "Staff help me to be as independent as possible, but are also there to help me when I need them" and another said "staff really know what they're doing and they always make sure my privacy and dignity is intact". One visitor told us "I know the care is good here".

Is the service responsive?

The records we looked at confirmed that people's individual care needs and preferences had been recorded and care had been planned and had taken place accordingly. We saw people's personal choices were respected, such as what time they wanted to get up or go to bed and whether they wanted to participate in activities or not.

Is the service well-led?

We saw there were quality assurance processes in place and people were asked for their feedback on the service they received on a regular basis. We also saw that the provider made changes to the service based on that feedback.

When we visited Frenchay Park Nursing Home we spoke with five people who lived in the home, two visitors, the registered manager and four members of staff. One person said “I like it here, they look after me because I can’t manage anymore. The staff are kind”. Another person said “I enjoyed that meal. The meals here are always good”. One of the visitors commented that “the staff really care for my friend”.

People received the care and support they needed because assessment and care planning processes took account of each person's needs, choices and preferences. Care plans were kept up to date and reflected the person’s current care needs.

People received the food and drink they needed to maintain their health and were supported to eat and drink sufficient amounts to meet their needs. They were provided with the appropriate level of support and were offered a healthy well balanced choice of meals.

People were looked after in comfortable and safe surroundings and improvements were being made to the facilities available. The home was in good decorative order throughout.

We found that there were effective recruitment and selection processes in place and people were looked after by suitable staff who had the required qualities and skills.

All records we asked to look at as part of the inspection process were made available to us. This evidenced the fact that there were good administrative systems in place which supported the good running of the home.

Improvements had been made to staff training and staff had the opportunity to attend sessions in regular scheduled training sessions throughout each month. Individual staff training files and a training matrix were being maintained by the registered manager and provided evidence that staff were being supported to do their jobs.

Because we visited Frenchay Park Nursing Home to check that improvements had been made with staff training, we decided to check that the provider was following safe recruitment practices. We looked at five staff recruitment files and found the service to be compliant with this outcome.

We spoke with people living in the home and relatives who were at the home when we visited. The majority of people who lived at Frenchay Park had difficulty in communicating verbally because of their physical or mental frailty. We were unable to ask most people about life in the home but we did receive the following comments from those that could speak with us, “everything is alright here and I get the help I need”, “everyone is very kind to me and all the staff are polite” and “everyone is kind and helpful and we can say what we would like to do”.

We spoke with one relative who was visiting and they told us their family member had previously lived in another residential home. They told us they were very satisfied with the way their family member was looked after and how improved their physical health had been since being at Frenchay Park Nursing Home.

We spoke with the manager, one registered nurse and some of the care staff who were on duty, about the people they were looking after. All staff knew what support each person needed. The staff encouraged people to manage their own needs where this was possible. They told us that they looked at the care plans if they needed to check out how a person was looked after and that they would feedback to the nurses when needs changed.