Park House provides a residential care service for up to five people living with mental health needs. At the time of this unannounced inspection of 4 August 2017 there were four people who used the service.

At our last inspection of 12 December 2014 the service was rated Good. At this inspection we found the service remained Good.

There was not 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. There was a manager in post and their application for registration had been received.

The service continued to provide a safe service to people. This included systems designed to minimise the risks to people, including from abuse, in their daily living and with their medicines. Staff were available when people needed assistance. The recruitment of staff was done safely.

People were supported by staff who were trained and supported to meet their needs. 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. Systems were in place to assess and meet people’s dietary and health needs and for people to maintain good health and have access to health professionals where needed.

Staff had good relationships with people who used the service. People were involved in making decisions about their care and support and this information was recorded in their care plans.

People received care and support which was planned and delivered to meet their individual needs. People were supported to participate in meaningful activities. A complaints procedure was in place.

The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.

We inspected this service on the 12 December 2014 and this inspection was unannounced. Park House provides support and care for up to five people who may have mental health difficulties.

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.

People received care that was personalised to them and met their needs and aspirations. The atmosphere in the service was friendly and welcoming.

People felt safe, were treated with kindness, compassion and respect by the staff. People were supported to maintain their health and well-being and encouraged to attend appointments with other healthcare professionals.

Staff listened to people and acted on what they said. Staff knew how to recognise and respond to abuse correctly. People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff understood how to minimise risks and provide people with safe care. Appropriate arrangements were in place to provide people with their medication safely.

People were supported by sufficient numbers of staff with the knowledge and skills to meet their needs. Staff respected people’s privacy and dignity and interacted with people in a caring and respectful manner.

Staff supported people to meet their individual needs and aspirations. People’s independence and maintenance of their health and well-being was promoted.

People were supported by the manager and staff to make decisions about how they led their lives and wanted to be supported. People voiced their opinions and had their care needs provided for in the way they wanted. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests.

People were provided with a variety of meals and supported to eat and drink sufficiently. People enjoyed the food and people were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

People were encouraged to pursue their hobbies and interests and participated in a variety of personalised, meaningful activities. People knew how to make a complaint and any concerns were acted on promptly and appropriately.

There was an open and transparent culture in the service. The manager and provider planned, assessed and monitored the quality of care consistently. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.

We spoke with three of the five people who used the service. We also spoke with three members of staff including the registered manager. We looked at three people’s care records. Other documentation seen included staff training and supervision, health and safety checks, maintenance records, provider quality monitoring reports, staff and resident meeting minutes and satisfaction questionnaires completed by the people who used the service.

We considered the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask; Is the service safe, Is the service effective, Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

People told us they felt safe, protected and their needs were met. One person said, “They (staff) are very decent and kind. It’s alright here; if I was worried about something they (staff) would help me to sort it out.”

We looked at the provider’s policies and procedures on safeguarding vulnerable adults from abuse. We saw that the safeguarding policy included information of the local procedures for reporting abuse and contact numbers for people to report any concerns. Safeguarding information was displayed in the service. This meant that people had access to information and who to contact if they had a safeguarding concern.

Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted, we saw that policies and procedures were in place. The registered manager confirmed that relevant staff had been trained to understand when an application should be made, and how to submit one. This meant that people would be safeguarded.

Records seen confirmed that staff were booked onto upcoming or had received training in safeguarding vulnerable adults from abuse, the Mental Capacity Act (MCA) 2005 and DoLS. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

We saw that there was enough staff on duty to meet the needs of people living in the service. The registered manager showed us the staff rotas. Records seen showed that people’s care needs were taken into account when determining the numbers, qualifications, skills and experiences of staff required for each shift.

Records seen confirmed health and safety was regularly checked in the service and equipment was maintained and serviced frequently.

Is the service effective?

People confirmed they were consulted about the care and support that they were provided with and understood the care and treatment choices available to them. One person told us, “They (staff) are very good. They remind me when it is time to take my medication. If I am not well they are quick to call the doctor. My foot has been sore and they (staff) got the doctor to come and see me.”

The care records seen showed that people's needs were assessed and care, treatment and support was planned in line with their individual care plan. This meant that people’s needs were met.

Is the service caring?

We saw that staff interacted with people living in the service in a caring, respectful and professional manner. People told us they were happy with the care they received and their needs were met. From our observations and from speaking with staff it was clear that they had a good understanding of the people’s care and support needs and knew them well. One person told us, “I can do most things myself. I am very independent and the staff here know that and let me get on with it. But they help me with the things I am not so good at and remind me so I don’t forget stuff that’s important; things like appointments and medication. This is good as it stops me worrying.”

Is the service responsive?

We saw that people had access to activities that were important to them and were supported to maintain relationships with their friends, relatives and links within the community.

People told us they met regularly with their key worker to discuss what was important to them. Care records seen documented people’s preferences, interests and diverse needs and, where required, the level of support required to assist people in achieving their goals and aspirations.

We saw that the service acted on feedback from people living in the service. For example a day trip was being arranged following a suggestion made at a recent ‘resident meeting’.

Is the service well-led?

We saw that the provider had systems and procedures in place to regularly monitor and assess the quality of the service provided. Where issues were identified we saw actions in place to address any shortfalls.

We looked at the outcomes from the last annual satisfaction survey which provided people with an opportunity to comment on the way the service was run. Feedback was positive. We saw that actions to address issues raised were either completed or in progress. This showed us that people's views and experiences were valued and taken into account.

We spoke with four of the five people who used the service. They told us their needs were met and staff treated them well.

People told us about the choices they made in their daily lives. One person told us, "I can go out when I want to, eat what I want, I like living here." Another person said "I go out when and where I like." They also told us, " I love living here, No complaints, I like it."

We looked at the care records of three people who used the service. The records showed that people's needs were assessed and care and treatment was planned in line with their individual care plan. We saw evidence in the care records that people received safe and coordinated care, treatment and support where more than one provider was involved.

We saw that people who use the service were provided with a clean and hygienic environment to live in.

We saw that staff interacted with people in a friendly, respectful and professional manner. We saw that staff sought their agreement before providing any support or assistance.

We looked at two staff files and found evidence that showed the staff received regular supervision and training necessary to care for the people who used the service. We also saw records that showed staff were supported in their ongoing professional development and were undertaking relevant qualifications.

We looked at the way that complaints were recorded and dealt with, and saw that they were handled in line with the provider's policy.

We met the three people who used the service and two of them agreed to speak with us. They told us that they were happy with the service they were provided with. One person said "I am happy living here."

People told us that their views and choices were listened to and acted upon. Staff treated them with respect and respected their privacy. One person said "The staff are very kind." Another person said "Of course they (staff) treat me with respect."

During our visit to Park House people told us that they were happy living at the home, they felt supported by staff and enabled to make choices about what activities they took part in and weekly menus.

We observed people engaging with their surroundings, talking to staff and being part of every day activities.