About the service: Chase Park can accommodate 60 people in two adapted buildings. There were 42 people living at the service when we inspected. Facilities include a coffee shop and swimming pool area, accessed by members of the public.

People’s experience of using this service: People received person-centred care which promoted positive outcomes to their well-being and independence. Care records detailed how people liked to be supported and were individual to the person. The service worked in partnership with other health and social care agencies to support people’s rehabilitation.

There were regular reviews of people’s needs to make sure they received the support they required. People had regular input other health care professionals and external agencies, for example GPs and therapists.

Environmental risks had not always been identified and assessed. Individual risks to people had been fully assessed and mitigated to help keep people safe. Medicines were not always managed safely; there were gaps in people’s medicine administration records. This meant people may not have had their medicine administered.

There was a governance framework, designed to assess the quality and safety of care, which was not always effective. The management team completed audits of the service and created action plans to improve the quality and safety of the service. However, these did not include actions to mitigate the risks we found.

Staff were kind and caring with people; they respected their privacy and dignity. People received safe care from a competent staff team. Some staff had not completed the required training.

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.

People were supported to attend activities in the local community and within the service. People were encouraged to maintain social relationships.

Following the last inspection, we asked the service to complete an action plan detailing what they would do and by when to improve the key questions of safe and well-led to at least good. At this inspection we found the service had addressed the initial safety issues identified at the last inspection. However, we identified new risks and safety issues during this inspection.

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

We identified a continued breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to the safety of the service. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: Requires Improvement (report published August 2018). This is the second time the service has been rated as requires improvement.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service through information we receive from the service, provider, the public and partnership agencies. As part of our process we will be meeting with the provider and requesting an action plan to be completed to address the issues identified. We will re-visit the service in-line with our inspection programme . If we receive any concerning information we may inspect sooner.

We carried out an unannounced comprehensive inspection of this service on 4 and 14 July 2017. At that inspection the service was rated ‘Good’ overall and there were no breaches of relevant regulations. After that inspection we received concerns in relation to staffing levels, the safety of people and the governance within the service. As a result we undertook a focused inspection of Chase Park Neuro Centre on 13 and 16 April 2018 to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Chase Park Neuro Centre on our website at www.cqc.org.uk.

Chase Park Neuro Centre is ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Chase Park can accommodate 60 people in two adapted buildings and on the date of this inspection there were 39 people living at the service and 15 people receiving respite complex care. Most of the people living at Chase Park Neuro Centre had fluctuating capacity due to an underlying medical condition or injury. There is also a coffee shop and swimming pool area, accessed by members of the public that are attached to the care home building.

There was a registered manager in post who has been registered with the Care Quality Commission (CQC) to provide the regulated activity since November 2016, this was one of the requirements of the home’s registration with the CQC. 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.

During this inspection we found a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014 Regulations: Safe care and treatment, and regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014 Regulations: Good governance. This was because the provider had not adequately assessed the risks to the health and safety of people using the service and the management of medicines was not safe. You can see the action that we have asked the provider to take at the back of the full version of this report.

We found the premises were not always safe. Designated fire escape routes were used as storage areas for staff belongings, the sluice and clinical waste storage areas were not locked and oxygen was not safely stored. This practice increased the risks of injury to people using the service.

Procedures were in place to ensure the safe receipt, storage, administration and disposal of medicines. However, we found medication administration records (MARs) had not been completed correctly and the medicines trolley was left unattended in front of the main entrance to the building. People's care records were left in the main corridors of the home which were easily accessible to other people and visitors.

People told us that they felt safe at the home and relatives agreed with these comments. We found there were policies and procedures in place to help keep people safe which were being followed by staff. Staff had received training and attended supervision sessions around safeguarding vulnerable adults. Staff were able to tell us basic safeguarding practices, what to do if they needed to raise a safeguarding concern and what they did to keep people safe. Accidents and incidents were recorded correctly and if any actions were required, they were acted upon and documented. Staff were safely recruited and they were provided with all the necessary induction training required for their role. The registered manager continued to provide on-going training for st

The inspection took place on 4 and 14 July 2017 and was unannounced. This was the first inspection of the home since the current provider took over management in July 2016.

Chase Park Neuro Centre is registered to provide care to 60 people aged 18 years or over. At the time of this inspection there were 47 people living at the home, three of these were respite admissions. The home provides rehabilitation and nursing care to people with a neurological condition as well as older people. The service is provided across two buildings.

The home had 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.

The provider’s approach to gathering feedback about the service from people and relatives lacked structure. Regular meetings did not take place. People had not been included in previous consultation. We have made a recommendation about this.

People told us they were well cared for. They said staff were kind and caring and they were treated with respect. Staff supported people with developing and maintaining their independence. People and staff told us the home was safe.

Staff had a good understanding of safeguarding and the provider’s whistleblowing procedure. Although they had no concerns about people’s safety, they knew how to raise concerns if needed.

Previous safeguarding concerns had been dealt with in line with the provider’s safeguarding procedure and referrals made to the local authority safeguarding team.

The provider had taken measures to ensure there was enough staff on duty to meet people’s needs. Most people said staffing levels had improved. Staff confirmed there was sufficient staff to meet people’s needs. Staffing levels were monitored periodically to check they were still appropriate to meet people’s needs.

There were effective recruitment procedures in place to check new care workers were suitable to work with people living at the home.

Records confirmed medicines were managed safely. People received their medicines from trained and competent staff.

Regular health and safety checks and risk assessments were carried out to help keep the home safe. For example checks of electrical safety, gas safety, fire-fighting equipment, emergency lighting and specialist moving and handling equipment. Procedures were in place to help ensure people continued to receive care in emergency situations.

Accidents and incidents were logged, investigated and monitored.

Staff confirmed they received the support and training they needed. Records we viewed confirmed this.

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.

People’s cultural and religious needs had been assessed and adaptations made to their care. For example, offering an adapted diet to meet religious requirements.

People were supported to have enough to eat and drink. Where people required specific support or specialist advice and guidance this was provided.

People had access to external health care services in line with their assessed needs. This included GPs, community nurses, speech and language therapists, physiotherapists and occupational therapists.

People had the opportunity to be involved in planning their care. People’s needs had been assessed including identifying their preferences and the information was used to develop individualised support plans. These had been reviewed to keep them up to date with people’s changing needs.

Activities were provided and people could choose to participate. These included activities both inside the home and in the local community, such as sho