About the service: Park Mount Care Home is a purpose-built care home for older people. It is located in Macclesfield. The home has capacity to accommodate 40 people in single en-suite rooms on two floors and also has one double room. It has two lounges, two dining rooms, a garden which is accessible to people, and a chapel where regular services are conducted and all denominations are made welcome.

People’s experience of using this service:

People said they felt safe living at the home. We followed up some feedback in relation to staffing numbers, however, the registered provider demonstrated and our observations showed there were enough staff on shift to keep people safe. Medication was managed safely, and there was a process to analyse incidents and accidents. The environment was safe.

People were offered choice and control over their day-to-day lives and consent was obtained People were supported to manager their nutrition and hydration needs. We discussed the décor of the home and how this could be further improved to support people living with dementia. Staff had the skills and knowledge to support people effectively.

We observed kind and caring interactions between staff and people who lived at the home. Staff discussed how they preserved people’s dignity and respected their feelings. People were involved in the completion of their care plans, and any reviews.

Complaints were dealt with in line with the registered providers complaints process. There was detailed information documented in people’s care plans in relation to what they liked, disliked and their preferred routines and choices for support. Staff were trained in end of life care, and people received support to ensure their last wishes were respected.

The registered manager completed audits of service provision and we saw that action plans were completed when issues were identified. People and their families were regularly asked for feedback and this was taken into consideration when making changes at the home. The registered manager was knowledgeable of their role and had notified the Care Quality Commission appropriately of any reportable events.

Rating at last inspection:

Rated good, report published September 2016.

Why we inspected:

This service was due to be inspected in line with our methodology.

Follow up:

ongoing monitoring

The inspection was unannounced and took place on 5 and 6 September 2016.

Park Mount Care Home is a purpose built care home for older people. It is located in Macclesfield. The home has capacity to accommodate 40 people in single en-suite rooms over two floors and has one double room. It has two lounges, two dining rooms and a large garden which is accessible to residents and a chapel where regular services are conducted and all denominations are made welcome. Access between the floors is via a passenger lift and there is car parking to the front of the building.

The service was last inspected in May 2014 which was a responsive inspection following a concern around medication. We followed this up in August 2014 when we found the service to be compliant.

The home has a registered manager. 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. At the time of our inspection there were 39 people living in the home.

We found that people were provided with care that was safe, person centred, sensitive and compassionate. The home was managed and staffed by a consistent team of care assistants who were well supported.

We saw that the service had a safeguarding policy in place. This was designed to ensure that any safeguarding concerns that arose were dealt with openly and people were protected from possible harm. All the staff we spoke to confirmed that they were aware of the need to report any safeguarding concerns.

We looked at recruitment files for the most recently appointed staff members to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

We found that there were sufficient staff deployed to meet the needs of the people living in the home. The manager had identified the need to increase the staffing numbers and was taking action to address this.

The provider had their own induction training programme which was designed to ensure that any new staff members had the skills they needed to do their jobs effectively and competently. This resulted in staff having the skills and knowledge to carry out their jobs well and provide safe and effective care.

We asked staff members about training and they all confirmed that they received regular training throughout the year and that this was up to date and provided them with knowledge and skills to do their jobs effectively.

People had care plans which were personalised to their needs and wishes. Each care plan contained detailed information to assist support workers to provide care in a manner that respected the relevant person’s individual needs, promoting their personal preferences’.

People living in the home told us that the standard of care they received was good. Comments included, “You couldn’t have a nicer group of staff, nothing is ever too much trouble for them” and “They treat me well. I’m happy with how they look after me”. Relatives spoken with praised the staff team for the quality of care provided. They told us that they were confident that their relatives were safe and well cared for. One person told us, “I’m so happy he is here”.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This meant that staff were able to help and support people who had difficulty in making decisions and ensured that plans were put in place in the person’s best interests. We saw that applications had been made appropriately.

There was a flexible menu in place which provided a good variety of food to people using the service. People living t

We visited Park Mount Care Home at 8.30 p.m. We talked to staff, looked at records and observed how medicines were being stored and administered. We were concerned to find that the medicines were being administered by staff who did not have the competency and skills needed to undertake this task. Procedures were not clear about medicines prescribed “as required” (PRN) were handled and used. Medicines were not stored securely.

When we visited Park Mount Care Home we spoke with eight of the people who used the service together with four visitors. We also spoke to four members of staff as well as the manager.

We checked that the provider obtained consent before providing care and treatment. People told us “The staff here are so good – they always ask before they do anything and will repeat things if you can’t understand” and “They never treat me like I can’t think for myself”.

We spent time looking around the building and checked the records. People spoke highly of the food provided. One person said “The food is wonderful – I am fairly particular but it’s great”. Another person said “The food is excellent – couldn’t get better in the best of hotels”.

People who used the service as well as their relatives generally spoke highly of the service provided at Park Mount Care Home. We spoke with a professional who confirmed this. One relative described it as “a home which is homely”. However we heard some concerns about the level of staffing at night times and the impact this might have on the care of people.

We looked at some of the records kept at Park Mount Care Home relating both to care and to staffing. We found that these met the requirements relating to recruitment of staff and that care records were up to date.

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

When we inspected Park Mount Care Home we asked staff to show us how they recorded care plans, and looked in detail at a sample of those plans. We also talked to the deputy manager in detail about these records.

During our visit to the home we spoke with six people who lived there and one visiting relative. They all told us they were looked after well and treated in a caring way with dignity and respect. For example, one person said; “The carers treat me how I would like to be treated.” Another said; “We are looked after extremely well. Staff are friendly and kind.”

They also said they were able to do the things they wanted to do. For example, all told us they could get up and go to bed when they wanted and could choose whether they wanted to be involved in activities. Several people told us they had recently been asked for suggestions about activities and trips they would like to go on.

All the people we spoke to said they were happy living in the home. They told us that staff were kind and caring, looked after them well and helped them when they needed. None had any concerns about their care. For example, one person said; “This feels like a home to me. It is not clinical or regimented.” Another said; “I am happy here. I have the help I want when I need it.”

Overall we found significant progress had been made since our previous visit in January 2012. For example, we saw people’s care and welfare needs being met appropriately, staff had sufficient support and training to carry out their roles competently and new quality assurance mechanisms had been introduced to monitor the quality of service provision. However, the accuracy and completion of documentation still needed improvement. This is consistent with feedback we had received from health and social care professionals visiting the home.

During our visit to the home we spoke with five people who live there. They told us they are looked after well, are treated properly and with respect and are able to do the things they want to do. For example, one person said, "The staff are friendly and treat me as a person”. Another said, “I have the choice to do what I like”.

All the five people we spoke to said they were happy living at the home. They said staff looked after them in a kind and caring way and they got the care and support they needed. One person said, “Its very good here, staff are kind and helpful”. Another said, "I have never heard a member of staff say that anything is a trouble for them”.

The social services professionals we spoke to were less positive about the home and were concerned that people were not receiving safe and effective care. For example, they had concerns that people’s care and welfare needs were not being met appropriately, staff have had insufficient leadership, support and training to carry out their roles competently and there was inadequate quality assurance and monitoring of service provision.