About the service:

Park House Nursing Home is a residential nursing home in the Queensbury area of Bradford. The home provides accommodation, personal care and nursing care for older people and people living with dementia. At the time of our inspection there were 21 people using the service.

People’s experience of using this service:

People and relatives told us that the service was caring and well led.

People received safe, person centred and good quality care.

Medicines were being administered safely and people’s dietary and healthcare needs were being met.

Staff were consistent and knowledgeable and received good training and supervision to ensure that they could carry out their roles effectively.

The registered manager provided staff with leadership and was visible and approachable.

The service met the characteristics for the rating “good” in all key questions .

Rating at last inspection:

At the last inspection on 26 July 2016 the home was rated good.

Why we inspected:

This inspection was part of our routine scheduled plan of visits.

Follow up:

We will continue to monitor the service to ensure that people receive safe, high quality care. Further inspections will be planned for future dates.

The inspection took place on 26 July 2016 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Park House Nursing Home on 3 January 2014, at which time the service was compliant with all regulatory standards inspected.

Park House Nursing Home is a residential nursing home in the Queensbury area of Bradford, providing accommodation and personal care and nursing care for up to 25 older people. There were 21 people using the service at the time of our inspection, 18 of whom were living with dementia.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like directors, 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 were sufficient numbers of staff on duty in order to safely meet the needs of people who used the service and to maintain the premises. All areas of the building were clean and well maintained, including external areas.

Staff were trained in safeguarding and displayed a good knowledge of safeguarding principles and what they would do should they have any concerns.

People who used the service and their relatives expressed confidence in the ability of staff to protect people from harm.

Effective pre-employment checks of staff were in place, including Disclosure and Barring Service (DBS) checks, references and identity checks.

The storage, administration and disposal of medicines was safe and in line with guidance issued by the National Institute for Health and Care Excellence (NICE).

Risk assessments took into account people’s individual needs and staff displayed a good knowledge of the risks people faced and how to reduce these risks.

People received the treatment they needed through prompt and regular liaison with GPs, nurses and specialists.

Mandatory staff training was regularly updated to ensure staff had a good working knowledge of people’s needs, whilst the Care Certificate modules were used to help refresh staff knowledge. Staff had received training in Fire training, Pressure Ulcer Prevention, Manual Handling, Mental Capacity Act, Continence Care, Equality and Diversity, Infection Control, Control of Substances Hazardous to Health (COSHH), Health and Safety, Dementia Care, Falls Awareness and Safeguarding

Staff received regular supervision and appraisal processes as well as regular team meetings.

We checked whether the service was working within the principles of the MCA. Staff displayed a good understanding of capacity and consent and we found related assessments and decisions had been properly taken and the provider had followed the requirements in the DoLS.

The atmosphere at the home was calm and welcoming. People who used the service, relatives and external stakeholders told us staff were patient and dedicated and we observed staff interacting with people in this way. We received a range of unanimously positive feedback from relatives and external professionals about the caring attitudes of staff and how they delivered the culture and values of the service. The premise of treating people who used the service as staff would their own relatives was well evidenced and indicative of a caring service.

Person-centred care plans were in place and staff had ensured a comprehensive amount of information about each person was readily accessible. We saw regular reviews took place with the involvement of people and their family members.

Group activities took place regularly, such as trips away from the home and in-house entertainment. Likewise, one-to-one time was offered to people by the activities co-ordinator. There was an opportunity to improve the way group activities were planned – currently people’s life history documents were not consulted to ens

We talked with six people who used the service, and five relatives.

People experienced care, treatment and support that met their needs and people were protected from the risks of inadequate nutrition and dehydration. People and their relatives told us they were satisfied with the service and would recommend it. One person said “They were looked after to the end degree”. We saw people were supported to have adequate food and drinks, and where staff had identified people were at risk of not consuming enough food or drink, they had put actions in place to ensure their nutritional needs were met.

We found people who used the service or their representatives were consulted about and their agreement sought before people were offered or received any care and their preferences were followed. Relatives told us staff “Kept them up to date” and two people told us staff “Did explain what they were doing and why”.

The home had systems in place that ensured a consistent approach to infection control and reduced the risk and spread of infections. People who used the service and their relatives told us the home was always clean. They told us their rooms were cleaned “Every day” and were always “Spotless”.

There were appropriate checks undertaken before staff began work. People and relative’s told us staff had a “Very supportive and nice attitude”. Two people said when they used their call bells or asked staff for support they were quick to respond, if they could not respond immediately they would always explain why and come back at the agreed time.

People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People told us they were able to discuss what help they needed and staff were obliging. One person said, “The girls listen to me. They do their best for me. I like living here.”

Care and treatment was delivered in a way that ensured people's safety and welfare. People who lived at the service and some visiting relatives told us that all staff including the manager were involved in the delivery of care. A relative said, “They are all hands on. That’s what we like about this home.”

People were provided with a choice of suitable and nutritious food and drink. We arrived during lunchtime and observed people having lunch. People we spoke with said the food was good and they got choices at meal times. One person said, “The food here is lovely. It’s freshly cooked.”

Medicines were safely administered. We observed the nurse administering medication and asking people whether they had pain or discomfort. People were observed by the nurse to ensure they had taken the medicines before leaving them.

We found people were comfortable, looked happy and were chatty. The staff interacted with the people in a positive and friendly manner. There was a calm atmosphere which promoted people’s wellbeing. We witnessed visitors using the open door policy of the manager to discuss issues.