This inspection took place on 11 January 2019 and was unannounced.

Hengoed Park is a residential home for up to 31 people with mental health needs, predominately supporting people who have had alcohol and substance misuse problems. The home is situated in its own grounds near the village of Gobowen. The main house provides accommodation for up to 22 people and a further 9 people live more independently in bungalows within the grounds. At the time of the inspection the service was full.

Hengoed 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Hengoed Park had a registered manager who has worked at the home for three years. 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.

We looked at how the service managed its recruitment of new staff and saw that this was done well. Staff received a detailed induction, had regular access to training and support from the registered manager, the deputy manager and the team leaders. Training was provided to staff to enable them to support people’s very specific needs.

We spoke with seven people who lived in the home who all gave positive feedback about the home and the staff who worked in it. They told us that the staff supported them to live their lives as independently as possible.

We found that staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw they had positive relationships with the people in their care and knew them well.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were kept safely with appropriate arrangements for storage in place.

Care plans were person centred and driven by the people who lived in the home. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required. The home employed a care plan coordinator who received support from the registered manager to ensure that all the care records were maintained and that people were actively involved in planning their care if they wished to. Other people in the home were less interested in the management of their care.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected.

The registered manager and deputy manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. They also regularly spoke with the people who lived in the home and used questionnaires to gain feedback about the care offered. The management team told us that they had an excellent working relationship with the provider who was always available when required.

Further inf

The inspection was carried out on 23 June 2016 and was unannounced.

Hengoed Park is registered to provide accommodation with personal care for up to a maximum of 31 people. Hengoed Park provides specialist support for people who misuse drugs and alcohol. There were 31 people living at the home on the day of our inspection. 22 people were living in the main building and the remaining nine people lived in self-contained bungalows within the grounds.

There was a registered manager in post who was present during 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 felt safe as staff monitored their wellbeing and were always available to support them when needed. There were enough staff to support people’s health and social needs. Checks had been completed to ensure potential staff were suitable to work with people before they started to work at the home.

People were protected from harm and abuse by staff who were able to recognise the signs of abuse and knew how to report concerns. Staff were aware of the risks to people and how to minimise them without restricting their independence.

Staff encouraged people to be involved in decisions by providing information in a way they could understand. Staff sought people’s consent before supporting them and respected their right to decline support. Where people were unable to make certain decisions for themselves these were made in their best interest by relatives and professionals who knew them well.

People were supported by staff who had the skills and knowledge to meet their individual needs. Staff received training relevant to their roles and felt well supported by the registered manager.

People enjoyed the food they received and were encouraged to follow healthy diets. Snacks and drinks were made readily available to people. People’s medicines were managed safely and they were supported to see health care professionals as needed.

People and relatives felt staff treated people with kindness and respect. People were given choices and felt listened to. Staff promoted people’s dignity and supported people to develop their independent living skills. People were supported to keep in contact with friends and relatives who were important to them.

People received support that was tailored to their individual needs and preferences. Staff knew people well and were able to recognise and respond to changes in their needs in a timely manner.

People knew how to raise concerns or make a complaint and were confident that they would be addressed by the registered manager. People were encouraged to give their opinions on the development of the service through meetings held at the home and through surveys.

People found staff and the registered manager easy to talk with and were complimentary about the quality of the service. There was a positive working culture at the home where staff were motivated by the registered manager’s enthusiastic approach. There was a clear vision for the service which was shared by staff. Staff felt that the registered manager provided effective leadership and looked for continual improvement.

A single inspector carried out this inspection. We carried out the inspection to check that the provider had made the necessary improvements to address shortfalls identified at our last visit in May 2014 with regards to assessing and monitoring the quality of service provision.

The focus of the inspection was to answer one key questions; is the service well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. As part of this inspection we spoke with five people who used the service, five staff and the management team.

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 well led?

Most people spoken with told us they were happy with the care they received. One person told us, “I’m very happy here, I don’t know why anybody wouldn’t be. I wouldn’t want to be anywhere else.”

An effective system was in place to regularly assess and monitor the quality of service that people received. Questionnaires had been introduced to seek the views of visiting professionals and relatives about the service people received. Residents' meetings had been introduced.

A replacement manager had been recruited and was in the application process of registering to become the registered manager of the home. An independent consultant continued to support the staff team to drive forward improvements in the quality of the service.

A single inspector carried out this inspection. 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, their relatives 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?

Appropriate arrangements were in place to manage medicines. This meant that people were protected against the risks associated with medicines.

Staff told us that there were gaps in staff training in important areas such as health and safety and fire. This meant that people were potentially at risk of receiving care from staff who were not up-to-date in managing risks.

People told us that staff gained their consent to care and treatments. One person told us, “Staff ask permission, everything works here it’s incredible”.

Is the service effective?

People told us that they felt the service met their needs. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs.

People were protected from the risks of inadequate nutrition and dehydration. People were provided with a choice of suitable and nutritious food and drink, which was freshly prepared in the service. Special diets were catered for including diabetic, vegetarian and soft diets.

Is the service caring?

Staff interactions were supportive and respectful. We observed a relaxed, yet respectful atmosphere in the service. All five people spoken with told us they were happy living at the service and felt safe. We were told, “This is a lovely place, there are never any problems here”.

Is the service responsive?

People told us that they had not been asked their views about the service they received. At the time of our inspection, there were no residents’ meetings taking place. There was however, a suggestion box available in the reception area of the home for people to leave their comments. Staff told us that the provider had not sought the views of people using the service or their representatives formally, for example through the use of satisfaction questionnaires.

People told us they had not had a reason to complain about the service they received. They told us that knew what to do if they had a complaint and felt confident that their concerns would be listened to. We were told, “I just have to ask and I get what I need”.

Is the service well led?

The service was without a registered manager at the time of the inspection. The former manager had left the previous month. Steps had been taken by the provider to recruit a replacement manager, who was due to commence employment in July 2014. In the interim period, the provider had commissioned the services of an independent consultant to work with staff to drive forward improvements in the quality of the service. Staff commented very positively on the contributions of the consultant who had been working closely with staff to identify priorities. Staff commented that they felt communication within the home had improved greatly with the support of the consultant.

At the time of our visit there was not a robust system in place for regularly assessing and monitoring the quality of the service. This meant that any shortfalls in the quality of the service were not identified quickly and rectified.

Hengoed Park provides accommodation and personal care for 24 people in its main house, and personal care only for a further seven people who live in self contained supported living homes in the grounds of the main house.

We spoke with four people who lived in the main house and two people who lived in the supported living homes. They were mostly generally pleased with the service they received. One person told us it was, “A privilege and pleasure to be here.” However, another person said, “There is such a variety of people here, they tend to treat you down to the lowest common denominator.”

Most people were able to make decisions for themselves. We found that where staff had assessed people as lacking the capacity to make their own decisions, they had not recorded how decisions were made on the person’s behalf or who had made the decisions.

We found that care plans were not centred on people as individuals. They were poorly organised and important information was spread over several different files for each person.

We found conflicting information on people’s care plans about their capacity to make decisions about their medication. We found inaccuracies in the recording of some medication.

We were satisfied that the provider carried out all the necessary checks on new staff before they were allowed to start work.

The home had a suitable system in place for dealing with complaints about the service it provided.

We visited the home on the 6 June 2012. There were 27 people living in the home on the day of the visit.

We spoke with eight people who live there, six staff, two medical and healthcare professionals, one visitor and the manager. We looked at selected care and staff files and other records related to the running of the home.

The home also provides personal care to people who live in separate bed sit accommodation in the grounds. Care and support is provided by the same staff with separate designated hours.

The home clearly has a very good ethos which sees people who live at Hengoed Park as individuals. We saw that people’s lifestyle choices and preferences were known about and respected by staff.

People were very satisfied with the care and support they received from staff and the manager. People spoke very highly of staff and everyone told us that they enjoyed living at the home. Some people commented that it was because the home provided a relaxed but stimulating environment with plenty to do. One person told us that they were “really well looked after” by staff.

On the day of our visit we saw people being supported sensitively and discreetly. Staff were seen to be mindful about respecting people's dignity and privacy and were seen to be involving people fully in relation to all decisions made.

Care plans contained good detail about people's life history, health and social care needs and their likes and dislikes. Care plans gave clear guidance and information for staff on how people's needs should be met and the importance of supporting people to retain life skills and independence.

Polices, procedures and training were in place to make sure that people who use the service were kept safe and the risk of abuse was known and minimised.

Staff were very knowledgeable about what constituted abuse and poor practice and were clear about how to report this should it occur. Staff felt that they had the training they needed to do their job well and were well supported by senior staff and management.

The home was clean, tidy and free from odours. The home was well maintained except the corridor carpets which were in poor condition. People were able to personalise their rooms and their choices and lifestyle were respected.

Very effective leadership was provided by the manager to ensure the quality of the service was maintained. The manager had an effective system to regularly assess and monitor the quality of service that people receive. Health and safety systems were in place to make sure that people who live and work in the home were safe.