Park Hill House is a ‘care home’. People in care homes receive accommodation and 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.

Park Hill House accommodates six people with a learning disability in one adapted building. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

At the last inspection on 28 September 2015 the service was rated Good. At this inspection we found the service remained Good.

People were safeguarded from avoidable harm. Staff adhered to safeguarding adults procedures and reported any concerns to their manager and the local authority. Staff assessed, managed and mitigated risks to people’s safety at the service and in the community. There were sufficient staff on duty to meet people’s needs. Safe medicines management was followed and people received their medicines as prescribed. Staff protected people from the risk of infection and followed procedures to prevent and control the spread of infections.

Staff completed regular refresher training to ensure their knowledge and skills stayed in line with good practice guidance. Staff shared knowledge with their colleagues to ensure any learning was disseminated throughout the team. Staff supported people to eat and drink sufficient amounts to meet their needs. Staff liaised with other health and social care professionals and ensured people received effective coordinated care in regards to any health needs. Staff adhered to the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. An appropriate well maintained environment was provided that met people’s needs.

Staff treated people with kindness, respect and compassion. They were aware of people’s communication methods and how they expressed themselves. Staff empowered people to make choices about their care. Staff respected people’s individual differences and supported them with any religious or cultural needs. Staff supported people to maintain relationships with families. People’s privacy and dignity was respected and promoted.

People continued to receive personalised care that meet their needs. Comprehensive assessments were undertaken to identify people’s support needs and these were regularly reviewed. Detailed care records were developed informing staff of the level of support people required and how they wanted it to be delivered. People were participating in a range of activities. A complaints process remained in place and any concerns raised were listened to and investigated.

The registered manager remained in post and adhered to the requirements of their Care Quality Commission registration, including submitting notifications about key events that occurred. An inclusive and open culture had been established and the provider welcomed feedback from staff, relatives and health and social care professionals in order to improve service delivery. A programme of audits and checks were in place to monitor the quality of the service and improvements were made where required.

Further information is in the detailed findings below.

This inspection took place on 28 September 2015 and was unannounced. At our previous inspection on 3 October 2013 the service was meeting the regulations inspected.

Park Hill House provides accommodation, care and support to up to six people with learning disabilities. At the time of our inspection five people were using the service.

The manager was in the process of registering with the Care Quality Commission. 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.

Staff were knowledgeable about people’s needs and how to support them with their personal care, social needs and activities of daily living. Staff were aware of how people communicated and responded promptly to their wishes and requests. Staff were caring, polite and friendly when speaking and interacting with people. Staff supported people to be involved in a range of activities and to access local amenities. People were encouraged and supported to be as independent as possible, for example, with meal preparations.

If people needed support to manage their health needs, staff liaised with the appropriate healthcare professionals. People received annual health checks from their GP and were supported to visit a dentist, opticians and any other medical appointments they had.

Staff supported people with their medicines and ensured they received their medicines as prescribed.

Staff supported people to make choices about day to day decisions. Staff were knowledgeable about the Mental Capacity Act 2005 and best interests meetings were held in line with the Act to make decisions on behalf of people who did not have the capacity to make decisions themselves. Deprivation of Liberty Safeguards were in place to protect people’s safety, and the staff were aware of what this meant and how to support people appropriately.

Staff had the skills and knowledge to support people, and this was updated through attendance at regular training. Staff were also supported by their manager through the completion of supervision sessions, which enabled staff to discuss their performance and obtain advice from their manager about how to further support people at the service.

The management team undertook checks on the quality of the service. Ensuring people received individualised care that met their needs, and that staff followed internal processes. Staff were knowledgeable about what processes to follow in the event of an incident, complaint or if they had any safeguarding concerns so that appropriate action could be taken to improve practice and protect people’s safety and welfare.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. Since our last inspection, a new manager had been appointed and they were in the process of applying to register.

Due to their needs, people that we met during our visit were unable to share their direct views about the standards of care. We therefore used observations and looked at care records to help us understand their experiences. We also looked at various records around the way the home was being run. We met with the new home manager, three members of staff and spoke with two people's relatives following our inspection.

People were supported by a stable staff team who had worked at the home for a number of years. We saw good interactions between staff and people who use the service. Staff knew how to respond to each person’s individual communication style and body language. Throughout our inspection, people were comfortable and relaxed in the company of the staff supporting them. One relative told us “I am quite happy." Another relative said, "I can't speak more highly of the set up." Both relatives told us the staff understood their family member's needs and that they were kept regularly informed about their care.

Care records provided up to date information about people's needs which meant that staff understood how to support each person and provide consistent care. Where people did not have mental capacity to consent, care was provided in their best interests. External professionals were involved in people’s care so that each person’s health and social care needs were monitored and met.

People had the right specialist equipment to promote their independence and meet their assessed needs.

Appropriate recruitment procedures were in place to make sure that suitable staff were employed to care for people. Robust audit systems were in place for monitoring and improving the quality of the service as needed.

People using the service had complex needs which meant they were not able to tell us their experiences. We spoke to the relatives of three people using the service. One relative said “I cannot speak highly enough about the quality of the care that my relative receives, staff are great and the organisation is fantastic. Another relative said “We are very pleased with the service. It’s a very nice home and the staff are nice and cooperative”. Another person said “I cannot fault the place, they do a good job”. All of the relatives we spoke to told us they visited the home regularly and said they had some input into planning their relatives care. All told us they knew how to make a complaint if they needed to.

We observed positive interactions between staff and people using the service during the course of our visit.

People living at Park Hill House do not have the capacity to share their views regarding their care. In order to make judgements about the care that individuals receive, we observed care practices; interactions with staff and tracked two people’s records of care. Case tracking means we looked in detail at the care people receive.

The reader should note that ‘PCP’ stands for person centred plan. This is a plan of care that is developed with a person using the service or their representative.

During our visit people were relaxed and at ease in their surroundings. We saw good interactions between staff and people who use the service. Staff were alert to changes in people’s mood, behaviour and general wellbeing and knew how they should respond to individual needs. People were engaged in activities both within their home and the local community.

We spoke to some people’s relatives and representatives. One told us, “Since moving to Park Hill, X is a different person and so well cared for. The staff are lovely, so obliging and we couldn’t wish for more. An excellent service!”

A social care professional described the service as “very good.” When asked what the home does well, they told us that the home prepared well for any review meetings and kept good contact with people’s families. They further added that “ the documentation is very good.”

The manager and staff team have developed good relationships with those who live at the home and understand their needs, wishes and aspirations to enable them to live a fulfilling life. Staff enjoy their work and described morale as ‘brilliant’. Comments from staff we met included ‘This feels like a home away from home’. ‘I don’t dread going into work. Sometimes I don’t even want to go home’ ‘The atmosphere motivates you to going that extra mile’. Staff described their line manager as an ‘open person’ with an open door policy.

Please refer to the outcomes within the main report for more detailed comments about specific aspects of the service.

We would like to thank all those who took part in this review for their time, assistance and hospitality.