This inspection took place on 5 and 6 June 2018. The 5 June 2018 inspection date and was unannounced, we told the provider one inspector was returning on the 6 June 2018 to review the governance of the service. At the last inspection we rated the service as Requires Improvement with three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. At this inspection we could see improvements had been made and the provider had met the regulations they were in breach of. However, we had identified a further breach and the provider continued to be rated as Requires Improvement overall. This is the second consecutive time the service has been rated Requires Improvement.

Haresbrook Park Care Home provides personal care and accommodation for up to 57 older people. There were 56 people living at the home on the day of our visit. The majority of people who live at Haresbrook Park live with an advanced dementia related illness or mental health illness. The home was split into two separate units, Country House, which supports people who have more complex health care needs and advance dementia related illnesses and Glen View which supports people who are more independent and have a dementia related illness or mental health support need.

Haresbrook Park 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 working at the home 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 2008 and associated Regulations about how the service is run.

People told us they felt safe with the care they received from the staff who supported them. Staff demonstrated good knowledge in how they were to protect people from harm, they recognised the signs of abuse and knew how to report most of this. However we found incidents between people who lived in the home had not been reported to the registered manager to ensure appropriate action was being taken to protect people. Where potential risks to people had been identified, staff did not consistently follow these to ensure the risk of harm was mitigated. There were enough staff to support people’s physical care needs, however the provider had not recognised that consideration was needed to allow staff time to support people’s emotional needs. People were supported with their medicines in a safe way. Staff understood the importance of reducing the risk of infection to keep people safe.

People’s care was assessed and reviewed with external healthcare professionals involved from the start. Improvements had been made to ensure people had enough food and fluid to keep them healthy. Where people required additional support with their eating and drinking staff knew who required this support. The registered manager had recognised where people were being restricted of their liberty and had sought the authorisations to do this. However where people had conditions within the authorisations these had not always been met to ensure people had maximum choice and control of their lives. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people.

Staff continued to be task focused in their approach and continued to not always recognise when people who lived with advanced dementia related illness required re-assurance and support. Where people were able to communicate their views and the decisions they had made about their care these were respected by staff who supported them. People and relatives felt the staff team were kind, friendly and respectful.

People received he

This inspection took place on 18 and 19 July 2017 and was unannounced. The inspection was brought forward earlier than planned due to concerns we had received from external healthcare professionals and a relative. At the last inspection in October 2015, the service was rated as good. At this inspection we found the service was requires improvement with three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Haresbrook Park Care Home provides personal care and accommodation for up to 54 older people. There were 52 people living at the home on the day of our visit. The majority of people who live at Haresbrook live with an advanced dementia related illness or mental health illness. The home was split into two separate units, country house, which supports people who have more complex health care needs and advance dementia related illnesses and Glen View which supports people who are more independent and have a dementia related illness or mental health support need.

There was a registered manager working at the home 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 2008 and associated Regulations about how the service is run.

The provider had responded to external healthcare professionals concerns around pressure area care. We found that while records did not always demonstrate staff were providing care in the instructed way, external healthcare professionals told us there had been an improvement to people’s pressure area care. People felt safe living in the home and staff recognised signs of abuse and knew how to report this. Staff did not always have time to spend with people; however staff worked as a team to ensure people were kept safe for harm. People’s medicines were administered and managed in a safe way.

We found that while the registered manager had identified that some people had their freedom restricted; this was not always done so in a legal way. This was because where people’s DoL authorisations had expired the registered manager had not submitted further applications to the supervisory body in order to gain the correct permission.

We found that where people lacked capacity to make decisions around their care and treatment, meetings with external healthcare professionals and the involvement of the person’s family had not been held to discuss what was in the person’s best interest.

Staff had received enhanced training around continence and pressure area care following concerns investigated by the local authority. Staff told us they needed training for dementia related illness so they could understand and support people in the right way that was individual to the person. People had access to their doctor or district nurse when they became ill or had an accident.

Where risks had been identified and monitored, staff had not always taken timely action with the information they had. We found that where identified weight loss, or low out-put of fluids had been recorded staff were unclear what next steps they would take. People told us and we saw that snacks and fresh fruit was not readily available to them.

People told us that staff did not have time to spend with them. Staff told us they felt frustrated they did not have the time to spend with people and support their emotional needs. People and relatives told us the staff were kind and caring. People spoke of the affection shown by staff and that they enjoyed this. We saw staff spoke to people respectfully and supported them in a dignified way.

There were assessments in place to ensure the provider could meet people’s needs when they came to live in the home. We found that whe

This inspection took place on 27 October 2015 and was unannounced. Haresbrook Park provides accommodation and personal care for up to 57 people. There were 54 people who were living at Haresbrook Park on the day of our visit. The home is split into two different areas; Country House had 29 beds for older people with dementia care needs. Glenview had 28 beds for people who had varying mental health needs.

There was a registered manager in place 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 2008 and associated Regulations about how the service is run.

People lived in a safe environment as staff knew how to protect people from the risk harm. Staff recognised signs of abuse and knew how to report this. Staff made sure risk assessments were in place and took actions to minimise risks without taking away people’s right to make decisions.

People told us there were enough staff to help them when they needed them. Staff told us there were enough staff to provide safe care and support to people. The provider used their own staff to cover any staff shortages, to support people with continuity of care. People’s medicines were checked and managed in a safe way.

People received care and support that met their needs and preferences. Care and support was provided to people with their consent and agreement. Staff understood and recognised the importance of this. We found people were supported to eat a healthy balanced diet and were supported with enough fluids to keep them healthy. We found that people had access to healthcare professionals, such as their doctor or the district nurse.

People were involved in planning their care. People’s views and decisions they had made about their care were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.

People to us they knew how to make a complaint and felt comfortable to do this should they feel they needed to. Where the provider had received a complaint, these had been responded to.

People felt listened to by the registered manager. The registered manager demonstrated clear leadership and staff told us they felt supported to carry out their roles and responsibilities effectively.

We found that the checks the registered manager completed focused upon the experiences people received. Where areas for improvement were identified, systems were in place to ensure that lessons were learnt and used to improve staff practice.