About the service:

Park Lodge is a small care home which is registered to provide care and support to four older people. When we inspected the home on 17 January 2019 four people who were living with dementia resided at the home.

People’s experience of using this service:

Regular quality assurance monitoring had been carried out in relation to people's care and support. Records had been updated where there were changes in people's needs. However we found that fire alarm and water temperature checks had not been routinely carried out and there was no annual audit of infection control. Following our inspection the manager sent information to show that fire alarm and hot water tests were now taking place. They also advised us that they would immediately carry out an infection control audit.

People told us they were happy with the care and support that they received from staff. They spoke positively about their care workers and the home’s manager.

Care and support was person centred and reflected people’s individual needs. People’s care plans and risk assessments had been reviewed regularly and updated where there were changes in their needs.

Staff communicated well with people and joined them in activities. Staff were able to communicate with a person who did not speak English.

Staff were knowledgeable about people’s needs and how these should be supported. They understood their roles and responsibilities in ensuring that people were kept safe from harm or abuse. They had received regular supervision and training to help them to care for people safely and effectively.

Staff supported people to make decisions about their care and support where they were able to do so. Information about people’s capacity to make decisions had been recorded in their care files. Applications for authorisations under the Deprivation of Liberty Safeguards (DoLS) had been made to ensure that people were not unduly restricted in any way.

Staff supported people to take their prescribed medicines. Accurate records of medicines administration had been completed.

People enjoyed their meals and their dietary needs had been catered for. They were offered choices at meal times and one person was provided with the cultural foods that they preferred.

People had good healthcare support. When people were unwell staff had immediately contacted healthcare professionals to meet their needs.

We made one recommendation in relation to ensuring that regular monitoring of safety at the home takes place.

Rating at last inspection:

Good (report published 7 September 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to inspect as part of our re-inspection programme.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This unannounced inspection took place on 4 August 2016. Our previous inspection took place on 15 August 2014 when we found all of the regulations we inspected were met.

Park Lodge is a privately owned and run residential care home for up to four older people. The manager lives on the premises and is responsible for the day to day running and management of the home. There were four people using the service at the time of the inspection.

There was a registered manager in place at the time of our visit. 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 found that people were happy at the home and good, person centred care was being provided in a homely environment.

The registered manager and staff were aware of what constitutes abuse and the action they should take if such an incident occurred. They received safeguarding training and policies and procedures were in place for them to follow.

There was sufficient staff to support people safely and to meet their individual needs.

Assessments were undertaken to assess any risks to people using the service and steps were taken to minimise potential risks and to safeguard people from harm.

Procedures were in place to ensure staff were suitable to work with people as staff had undergone the required recruitment checks.

Staff completed an induction programme and mandatory training in areas such as, fire safety, health and safety, infection control, moving and handling and safeguarding.

Records showed that staff had received regular one to one supervision. There was also evidence of regular annual appraisals.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005. The registered manager was in the process of applying for a DoLS authorisation for a person staying at the home to legally deprive them of their liberty.

Staff showed dignity and respect as well as demonstrating an understanding of people’s individual needs. They had a good understanding of equality and diversity issues and care plans included information on how equality and diversity should be valued and upheld.

Staff knew how to support people to make a formal complaint and complaints were logged and dealt with effectively, demonstrating the outcome of the investigation and how learning was shared.

Audits and quality monitoring checks took place regularly and annual service user satisfaction surveys were undertaken to ensure the service was delivering a high quality, person centred service.

A single inspector carried out a planned inspection and gathered evidence against the outcomes we looked at to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Sufficient numbers of appropriately skilled staff were provided to deliver people’s care needs. Staff had received the training they needed to provide safe and effective care and support. People's care was carried out in a way which took into account any identified risks and the management of these.

There were systems in place to analyse accidents and incidents in the home, to ensure lessons were learned and improvements were made to protect people. Records were accurately maintained, which meant the risk of people receiving unsafe care was minimised.

Is the service caring?

People (and their relatives) told us they were treated with respect and dignity by the staff. We observed people being supported appropriately and sensitively by staff. People told us they felt safe and we observed people being supported by kind, attentive and caring staff. We saw care workers showed patience and gave encouragement when helping people. One person told us, “They (the staff) look after me really well here.” A relative told us, “(my relative) can be very difficult to please but they (the staff) are very patient and caring.”

Is the service effective?

People’s health and care needs were assessed with their involvement. We found evidence to show they were always involved in agreeing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People we spoke with and their relatives told us they received the support they needed.

Is the service responsive?

A relative told us, “I’ve never had to make any complaints but I know they would take note if I did. They (the staff) always involve me and ask for feedback.” A person using the service told us, “I don’t have any complaints but I would soon tell them (the staff) if I did. They are always talking to me and asking me how I am.” We saw the provider ensured the welfare of people using the service by identifying and responding to any changes in their health and welfare.

Is the service well led?

We found that regular monitoring and reviews of the service were carried out with any highlighted actions completed in a timely manner. This meant the quality of the service could be assured by people living at Park Lodge, their relatives and staff.

Staff told us they felt supported by the manager. Comments included, “She (the registered manager) is very good and we work well together as a team."

At the time of our inspection, the home was providing care for three elderly people.

People who used the services received appropriate care and support that met their individual needs and they were treated with dignity and respect.

There were processes in place to protect people using services from harm and abuse. The staff were trained to recognise the signs of abuse and to report concerns in accordance with the home's procedures.

The staff were supported to provide care and treatment to people who used the service and were being trained, supervised and appraised appropriately.

The home had an effective system to regularly assess and monitor the quality of service that people receive and to identify, assess and manage risks to the health, safety and welfare of people using the service.

During our inspection on 27 April 2011 we found the provider non-compliant. The provider did not take proper steps to ensure people using the service were protected by having appropriate risk assessments in place, in addition to this recruitment procedure were not followed appropriately and people using the service were not protected appropriately. However, in our inspection on 21 June 2012 we assessed compliance with these regulations.

People using the service confirmed that risk assessments were in place and an example given was that staff encouraged people to use a walking aid which protected the person from falls and injuries.

We discussed with people and relatives if the staff provided made them safe, and comments made by people using the service included, "I have no concerns about the staff working here".

We asked people if they were able contribute to the level of care received and were able choose what they want to do.

People who use the service we spoke with told us that they understood what care and support was available to them. We saw staff doing a person’s finger nails, after discussing this with the person prior to commencing this activity. People told us that staff is treating them well and ensured their dignity and privacy were respected.

People had the opportunity to contribute to their care and decide the level of care they wish to receive from carers.

We spoke with people if they enjoyed their meals and had a choice.

People told us that they were happy with the meals offered and the choices the can make to receive suitable, tasty and well prepared meals.

We asked people if they felt safe at the home and if they liked living at Park Lodge.

People told us that they were safe at Park Lodge and felt staff protected them better than they could within in their own home.

People confirmed that they were happy at Park Lodge and the home was clean, tidy and free of any offensive odours.

We discussed with people if they were satisfied with staff and if staff was available in sufficient numbers. One comment made, “there is sufficient staff on duty and they are friendly and courteous, which is the most important thing”.

We asked people if they can make complaints about the care and service provided. People told us that they would complain to the manager and were confident that their complaints were dealt with.