We carried out an inspection of Park House Hotel on 27 February 2017. The inspection was unannounced. At the time of our visit, the registered manager was on annual leave, so we conducted an interview with them by telephone on 17 March 2017.

Park House Hotel is registered to provide accommodation and personal and nursing care for up to 24 people. Park House Hotel is a large historic building that has been adapted to ensure access for people with a physical disability. The service provides support for people who want to take a holiday break. The level of care and assistance required is assessed before guests stay at the service. The person receiving care or support is also able to have a family member, partner or companion accompany them.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Please note that as the staff refer to people as ‘guests’ due to the nature of the service provided, we have used this term throughout the full report and in previously published reports.

During this inspection guests said they felt safe and that staff treated them extremely well. Safeguarding adults' procedures were in place and staff understood how to protect guests from the risks associated with abuse, and were encouraged to raise and report any concern they had. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Risks associated with guests care were clearly identified, assessed and recorded.

Staff had been recruited safely and had been well trained. Staff had completed an induction programme when they started work and they were up to date with the provider's mandatory training. Staff received regular supervision and felt supported in their roles. They turnover of stall was very low and many had worked at Park House for a number of years.

Policies and procedures were in place to guide staff with the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to guests as prescribed and disposed of safely by trained staff.

Staff acted in a courteous, professional and safe manner when supporting guests. The registered manager and staff prided themselves on paying close attention to detail, and were passionate that guests stays were always of high quality. There was an ethos that guests would be able to have a relaxing and individual experience. There were enough staff on duty with the skills and knowledge to provide people with the support they needed. Staff were attentive and responsive, guests did not have to wait for their support, and any requests were quickly attended to.

The registered manager and staff understood the main principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation.

There were appropriate arrangements in place to support guests to have a varied and healthy diet. The food provided was of very high quality, guests had a wide range of meals to choose from, and the catering team was very flexible in their approach and planning. Guests had access to a GP and other health care professionals when they needed them.

There was a friendly and welcoming atmosphere within the service, contributed to by every member of the staff team. There was a strong ethos of high quality customer service at Park House. Staff provided guests with support in a very respectful and dignified manner, ensuring that they respected their privacy. Staff were kind, caring and compassionate, and often went the extra mile to provide them with high quality care. Guests felt valued by staff and had confidence in them, guests valued this as an ess

People were fully consulted before their stay at Parkhouse Hotel and their support needs were again discussed on admission. People told us they were always asked about how they wanted to be assisted and made decisions about their routines at each stay.

We looked at care plans that clearly explained how a person preferred to be supported. We saw information about the choices that people using the service had made, showing people were fully consulted at every stage.

People were provided with a choice of nutritional meals that met their dietary requirements. Staff had access to the kitchen and were able to provide snacks at any time of the day or night if needed. People told us that they just asked any time of day for a drink and it was made for them.

We saw that recruitment files contained appropriate references, background checks plus interview information, showing how new members of staff had been selected. This supported the safety and well being of people using the service.

There was a clear complaints procedure that staff followed in the event of any complaints being received. Although none had been received for some time, staff were aware of the processes to follow. An information booklet about how to make a complaint was given to everyone on admission.

During our inspection we spoke with five people who were receiving nursing or personal care during their holiday. We also talked with four people who were staying at the hotel to accompany their family member or friend but who did not have care needs.

People’s comments about the service they received at Parkhouse were positive. One person told us that they were provided with a unique service that they were unable to get anywhere else. People were satisfied with the care and treatment they received and said that it met their needs.

Everyone praised the staff team. We were told that staff were, “Helpful, kind and caring.” Two of the people we spoke with commented that staff had time for them and nothing was too much trouble.

We found the environment was safe. People were pleased with the grounds, which one person described as, “Exceptional.” However, we found that some of the décor and furnishings in bedrooms did not promote people’s wellbeing. One person told us that they thought their room was tired and in need of refreshing.

Staff received sufficient training, which helped them to understand the needs of people who use the service.

The manager had put systems in place to check that people received a quality service.

This inspection took place on Thursday 9 October and Monday 13 October 2014. The visit on the 09 October 2014 was unannounced and we arranged to go back to speak to more people using the service on 13 October 2014.

Park House Hotel is a large building that has easy access for people with a physical disability and is situated in the grounds of the Sandringham estate. The service provides support for people who want to take a holiday break. The level of care and assistance is negotiated prior to any visit and some people return to the service on a regular basis. The person receiving care or support is also able to have a family member or friend with them as the service also provides a certain amount of independent rooms as well as shared rooms to suit the requirements of the individual.

There is currently a manager who oversees the service but the registered manager has recently left. 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. There is currently a review of how the service operates and how senior staff work together to decide who will be best to take this position of registered manager.

Please note that as the staff refer to people as ‘guests’ due to the nature of the service provided, we have used this term throughout the full report and also in the summary of this service.

Guests who used the service told us that they felt safe and well cared for. They told us that staff had telephoned them before their arrival and made certain that their needs could be met. Menus were varied and guests had a choice of food, or they could request any special items they particularly enjoyed. Specific dietary needs were also met when necessary.

Staff had been trained to provide support to the people who required care and support. Any specific needs, for example regarding a guest’s emotional or physical needs, were fully researched and procedures developed prior to the person admission. Any equipment that was needed was also sourced before the guest was booked in, making certain that all needs were safely met.

People had access to healthcare professionals should this be necessary and every care plan had relevant details to ensure appropriate care was provided. Staff got to know regular guests and their preferences enabling continuity of care and support.

The staff told us that they enjoyed working at the service. They confirmed that the staff team worked together at Park House, discussions were open and honest. Any concerns or comments from guests were dealt with immediately and action was taken to quickly address the issue. Everyone worked together to make certain that the guest had an enjoyable stay.