Eirenikon Park is a ‘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. Eirenikon Park accommodates up to 13 people in one adapted building. There is also a domiciliary care service operating from the residential premises, which provides personal care to people in their own homes. At the time of the inspection there were 11 people living at residential service and 17 people receiving care in their own home.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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 carried out this unannounced inspection on 28 and 30 November 2017. At this comprehensive inspection we checked to see if the provider had made the required improvements identified at the inspection of 5 October 2016.

In October 2016 we found documentation relating to people’s medicines at the residential service was not always correctly completed, fridge temperatures were not always recorded and medicines were not always safely stored. Records did not indicate that people’s capacity had been assessed as required. Where people were likely to have reduced ability to make decisions, records did not indicate the type of decisions people could make or what decisions might need to be made in their best interest. There was no written evidence of best interest processes, to ensure that decisions reached were the least restrictive available.

At this inspection we found improvements had been made in all the areas identified at the previous inspection. This meant the service had met all the outstanding legal requirements from the last inspection.

Safe arrangements were in place for the storing and administration of medicines. People were supported to take their medicines at the right time by staff who had been appropriately trained. Staff explained to people what their medicines were for and ensured each person had taken them before signing medicine records.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. People had their capacity assessed appropriately. The service knew who had appointed lasting powers of attorney for either finances or health and these people were asked to consent on behalf of the person if they lacked the capacity to do this for themselves. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

On the day of the inspection there was a calm and relaxed at the residential service. We observed that staff interacted with people in a caring and compassionate manner. People told us they were happy with the care they received and believed it was a safe environment. Comments included, “I have been here for about a year, it's good enough for me”, “I am very happy here”, “Everything is OK” and “I feel safe knowing staff are around if I need them.”

People who received a service in their own homes said they were happy with the care provided. They also told us that they had a team of regular, reliable staff, had agreed the times of their visits and were kept informed of any changes. People commented, “All the staff are kind”, “The service always lets me know if staff are running late” and “Rarely has the rota gone wrong, my visits are when I need them.”

There were enough suitably qualified staff on duty and additional staff were allocated if peoples’ needs increased, such as when someone was unwell. Staff were supported by a system of induction training, one-to-one supervision and appraisals. Staff completed a

We carried out this unannounced inspection of Eirenikon Park Residential Home (known locally as “Eirenikon Park”) on 5 and 11 October 2016. Eirenikon Park is a care home which provides residential care for up to 13 older people. On the day of the inspection there were 12 people living at the service. There is also a domiciliary care agency operating from the service, which provides personal care to people in their own homes. At the time of the inspection, thirteen people were being provided with care in their own home.

The service had a registered manager in post. 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 previous inspection on 18 January and 2 February 2016 we found issues in relation to the management of medicines at the residential service. Medicines in stock for one person were inaccurate. Records had not recorded where the medicine had been refused therefore, the level of stock was inaccurate. Some medicines which had belonged to a person who had died had not been returned to the pharmacist. The registered manager was not carrying out audits of medicines which would highlight where issues were occurring. This meant people’s medicines were not being managed in accordance with medicine regulation and good practice guidance. At this inspection, some improvements had been made including the introduction of medicines audits, but some new issues relating to medicines management were identified.

Staff from both the residential and domiciliary service had received training relevant to their role and there was a system in place to remind them when it was due to be renewed or refreshed. However we found that many of the staff had lapsed in their refresher training in a number of subjects identified by the provider as mandatory, including medicines management. Staff were supported in their role by an ongoing programme of supervision, appraisal and competency checks.

Some staff were knowledgeable about the Mental Capacity Act and how this applied to their role. However where people had been considered to lack capacity to make certain decisions this had not been assessed or documented and there was no evidence of a best interest process. This meant that less restrictive alternatives to meeting their care needs may not have been considered. This applied to people who lived at Eirenikon Park and people who were supported in the community. Where people’s liberty was restricted for those living in the residential service, applications for DoLS authorisations had been made to the Supervisory Body. People were involved in planning their care and staff sought their consent prior to providing them with assistance.

We found that morale amongst staff from both services was mixed. Staff told us that dynamics between some staff members was difficult. This meant that some members of staff were reluctant to work with each other and this caused problems for senior staff when planning rotas. The registered manager was aware of the issue and was taking action to address it. New staff were being actively recruited.

There had been a recent environmental health inspection of the kitchen which had rated it as one out of five in terms of food hygiene. A number of issues were highlighted by that inspection as requiring improvement, however the registered manager was in the process of addressing this and many of the concerns had been resolved by the time of our inspection.

We observed positive, compassionate and caring interactions between people and staff in both the residential and domiciliary service. Staff knew the people they cared for well and spoke about them with kindness, fondness and affection.

People told us they enjoyed the food. People

We carried out this unannounced inspection of Eirenikon Park on 18 January and 2 February 2016. Eirenikon Park is a care home that provides residential care for up to 12 people. On the day of the inspection there were 10 people using the service. There is also a domiciliary care agency operating from the service. This service was providing personal care and support in the local community for approximately 16 people. The service was last inspected in February 2014 and met the requirements of regulation.

The service had a registered manager in post. 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.

There were suitable facilities available to store medication safely in the residential service. However, medicines in stock for one person were inaccurate. Records had not recorded where the medicine had been refused and therefore the level of stock was inaccurate. Some medicines which had belonged to a person who had died had not been returned to the pharmacist. The registered manager was not carrying out audits of medicines which would highlight where issues were occurring. This meant peoples medicines were not being managed in accordance with medicine regulation and good practice guidance. There were safe systems to manage people's medicines in their own homes. Records showed medicines were being administered at the prescribed times.

Records for people using the domiciliary care agency included evidence of people being involved in their care planning and reviews. In addition, people s consent was sought in respect of the care and treatment they were receiving. However, some records in the residential service required updating to show where involvement was taking place and consent had been sought. People told us they had been involved in their care planning and asked for their consent before any support was provided.

There were a variety of methods in place to assess and monitor the quality of the service. Meetings and surveys had taken place and showed people were engaged with and listened to. However, medicine audits had not taken place resulting in discrepancies in administration not being identified and acted upon.

Staff recruitment files contained the relevant recruitment checks, to show staff were suitable and safe to work in a care environment, including Disclosure and Barring Service (DBS) checks. However, whilst DBS confirmation numbers were recorded there were no dates included to show when the check had been received. It was therefore not possible to identify if the member of staff had commenced employment at the service after the DBS had been received. There were no commencement dates in place to confirm when staff had commenced working in the service. Pre-employment checks had been completed to help ensure staff had the appropriate skills and knowledge required, to provide care to meet people’s needs.

We have made a recommendation for the provider to address this.

There were sufficient numbers of care staff to support the needs of the people living at the service and using the domiciliary care service. People were being cared for by competent and experienced staff. People had choices in their daily lives and their mobility was supported appropriately.

Staff understood the needs of people being supported, so they could respond to them effectively. We observed care being provided and spoke with people who used the residential services and domiciliary care service, their families and healthcare professionals who visited the service regularly. All spoke positively about the staff and the registered manager. One person told us, “I love living here. The staff are all wonderful and caring”. A family member told us, “(Persons name) has

At the time of our inspection there were twelve people living at Eirenikon Park Residential Home. During our inspection we spoke with the registered manager, assistant manager and four members of staff. We also spoke with four people who use the service and three relatives. Additionally we spoke with a district nurse and looked at five care records of people who live in the home. We also looked at the replies of the questionnaires that the provider had sent to people.

People who live in the home told us they were happy, the food was okay and staff were okay and usually listened.

Relatives told us, "I am extremely pleased with the care X receives. I never announce when I am going and X is always clean and cared for. Overall I am very pleased". Other relatives told us, "Staff are friendly, X is looked after. There is always someone around. They get X ready on time for us to take out they are always appropriately dressed and presentable". Other relatives told us, "Excellent care, really good, helpful staff". A district nurse told us, "Brilliant, staff are very caring, they contact us if there are any worries".

We found people's needs were assessed prior to moving into Eirenikon Park Residential Home and on a regular basis once they were living there.

We found care and treatment was planned and delivered in line with people’s individual care and support plans. One person who used the service told us "I like living here, they look after me very well".

We found suitable safeguarding policies and procedures were in place. Access to information about local reporting procedures and contact telephone numbers was not readily available to all staff. All staff had received safeguarding, first aid, medicines management and infection control training. We were told staff were supported with supervision and there was always access to training.

We saw that the home was clean and tidy and that there were good infection control practices within the home. There were robust systems in place for ordering, storing, administering and disposing of medication. All staff had undertaken management of medicines training to ensure to ensure they were up to date with current good practice recommendations.

We observed staff and were impressed with the care and support shown to people using the service. People told us they were happy with the care they received at Eirenikon Park Residential Home.

One person said “it couldn’t be beaten” and ”‘the staff are really nice and kin”

We saw that people who use the service were very happy to approach any member of staff at any time and that they were asked if they were alright or if they wanted to talk about anything.

People told us that they thought the home was clean and they liked their rooms.

People told us that they think there are enough staff and they do not have to wait very long if they call for assistance.