Hundens Park is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during the inspection.

Hundens Park accommodates up to 47 older people in one building. People are accommodated over two floors, each of which have separate adapted facilities. The upper floor (Darnton Unit) provides support to people living with dementia. People with general nursing needs reside on the ground floor. On the day of our inspection there were 42 people using the service.

The inspection took place on 1 November 2017 and was unannounced. This meant staff did not know we were visiting.

We last inspected Hundens Park on 13 October 2015 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.

The service had a registered manager who was on duty during the course 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.

Accidents and incidents had been logged but we could not verify at the time of the inspection whether the registered manager had oversight of any trends or analysis since May 2017. The registered manager told us they had changed their recording system and there had been some miscommunication between the management team as to who had responsibility for this oversight. On the day of our inspection the management team agreed to revert to their previous system which they told us had worked well.

We saw that actions required from a fire risk assessment in July 2017 carried out by an external contractor were not clearly recorded for action or follow up. On investigation we found issues in relation to major building works were not clearly recorded on the service’s ongoing action plan. This meant we could not see if it had been actioned or who was accountable. The regional director discussed this with the provider’s health and safety director and it was found the service was not responsible but this was down to the provider’s health and safety department not updating the recording system but the works had been actioned. This was rectified on the day of our visit by updating the service’s action plan.

We have made a recommendation about the quality of oversight and action plans.

Staff and the management team understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults. People we spoke with told us they felt safe at the home. The registered manager shared learning from feedback and safeguarding events with the staff team through recorded meetings.

Where potential risks had been identified an assessment had been completed to keep people as safe as possible. Health and safety checks were completed and procedures were in place to deal with emergency situations.

The home was clean, and we saw staff followed good practice in relation to wearing personal protective equipment when providing people with care and support. The environment in relation to the first floor had much improved and was much more homely, accessible and dementia focussed.

Medicines were managed safely. We saw medicines being administered to people in a safe and caring way. People confirmed they received their medicines at the correct time and they were always made available to them. We saw nursing staff working with community professionals to ensure end of life anticipatory medicines were available to people when needed.

We found there were sufficient care staff deployed to provide people’s care in a timely manner. We saw that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. The regis

We inspected Hundens Park on 13 October 2015. This was an announced inspection.

Hundens Park care home provides care and accommodation for 47 people. The home is situated close to the centre of Darlington. All rooms are ensuite and there are two floors serviced by a lift. The home caters for older people some of whom may have dementia and also provides nursing care.

The service has a registered manager, who has been registered with us since September 2015 The registered manager was on annual leave 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.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of different types of abuse, what constituted poor practice and action to take if abuse was suspected. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. Staff told us that they felt supported. There was a regular programme of staff supervision and appraisal in place. Records of supervision were detailed and showed the registered manager, head of nursing and deputy manager worked with staff to identify their personal and professional development.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. There was enough staff on duty to provide support and ensure that their needs were met. Staff were aware of the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.

People’s nutritional needs were met, with people being involved in shopping and decisions about meals. People who used the service told us that they got enough to eat and drink and that staff asked what people wanted. Staff told us that they closely monitored people and would contact the dietician if needed. However, staff did not complete nutritional assessment documentation.

People were supported to maintain good health and had access to healthcare professionals and services. People told us that they were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

Assessments were undertaken to identify people’s health and support needs. Person centred plans were developed with people who used the service to identify how they wished to be supported.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. The activity co-ordinator had developed innovative sessions for people who had dementia.

The provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.

We spoke with eight people living at the home. We also carried out a Short Observational Framework Inspection (SOFI). SOFI is a tool to use if we are unable to find out people's experiences through talking to them (for example, if they have dementia or other cognitive impairments). We had to cease using this observation framework as one of the people living on the Darnton unit became very disruptive and aggressive. One person on the nursing unit told us they felt there was not enough staff and another said; “I like it here, the girls make me laugh”.

We spoke with three visitors to the home who had relatives on the nursing care unit on the ground floor. These relatives said they had raised concerns about staffing levels to the manager as they said there wasn’t enough staff to deliver personal and nursing care and also that some staff had “been moved” recently onto other units in the home which affected consistency. One visitor said; “Sometimes it takes ages to get someone to come”. We discussed this with the registered manager who explained there had been some staffing changes on the nursing unit and they were undertaking a review of the skills of staff working in the home and that staffing levels were appropriate to the service.

Records at the service were reviewed and held securely. There were systems in place to monitor the quality of the service by the provider and five staff we spoke with were clear about how to recognise and report abuse.

We spoke with eight people living at the home. Some people were not able to tell us directly what they thought about the service. However, during our visit we spent time observing how care staff supported people..

There was a specialist unit on the first floor of the home which catered for people with dementia. The environment had been specially adapted by the use of colour coded doors and memory boxes on doors to help people find their way around and to feel comfortable in their surroundings. Staff had also received training in supporting people with dementia.

People were positive in their views about the home. They told us; “The staff here are lovely”.

We observed lunch in one of the dining rooms and saw staff spend time with people and they supported them with dignity and respect. There were sufficient staff on duty to support people for their care needs.

We spoke with relatives and visitors to the home who were very positive in their comments about the care their relatives received. One person told us; “My mother receives excellent care and the staff tell us exactly what’s going on”.

We saw the provider had a complaints process in place with records to show issues had been responded to in a timely way

We visited this location on a weekday and were able to talk to five people who used the service. We were told that the staff are ‘absolutely fantastic’, ‘great’ and that the home rates as ‘ten out of ten’. People also said that staff ‘are smashing’, ‘excellent’ and that ‘the home is nice and comfortable’ and that the ‘food is tasty, there is enough.’

People who used the service confirmed that they had ‘no concerns’ and they knew how to discuss issues and with whom, staff were always friendly and that they had confidence in the staff. We were told that people who used the service were given care appropriate to their needs and that this was done in a ‘pleasant, spacious and clean’ home.

All of the people who were affected by the subsidence had been moved from the home and therefore it was not possible to discuss the issue with them.