About the service.

Offington Park Care Home is a ‘care home.’ The home is registered to provide accommodation and personal care for up to 24 older people. At the time of the inspection there were 22 people living at the home.

People’s experience of using this service:

The provider had not followed the West Sussex Fire and Rescue Service’s advice. There were no records of weekly testing of the fire alarms and monthly tests of the emergency lighting. The smoke detector system had not been extended to the office which was also advised by the fire and rescue service. Risks assessments were not carried out when bed rails were used to prevent people falling out of their bed.

Whilst people said their care needs were discussed with them, there was a lack of records that people had consented to care practices which restricted their liberty. The provider made applications to deprive people of their liberty for reasons of safety; these are called Deprivation of Liberty Safeguards (DoLS). However, the provider had not assessed whether or not people had capacity to consent to these restrictions before applying for DoLS.

The provider had introduced a new computerised care plan system. These computerised assessment and care plans varied greatly in detail. Some sections were incomplete whereas others were completed well.

The provider’s system to assess, monitor and improve the quality and safety of services was not effective. The system of checks had not monitored whether improvements had been completed. This included the advice of the fire and rescue services and routine fire safety checks. The provider used audits which had identified improvements were needed in the assessments and care plans but these were not fully actioned. At the time of the inspection, the registered manager was not available and the provider had difficulty locating some records. For example, the provider said surveys were used to check people’s views about the service but these could not be located.

People and their relatives said they were satisfied with the standard of care provided. For example, one relative said, “I can’t fault it.” People said they received individualised care and support which they had discussed with staff. Relatives and people said the staff were friendly and treated people with respect. One person, for example, said, “It’s marvellous. I get a lot of attention. The staff are very nice. Kind. They do all they can to help you. They always come when you ring the bell.” Staff demonstrated they promoted values of treating people with respect and dignity. Staff said they treated people as they would treat a family member. Staff were observed to talk to people with respect and in a polite and friendly manner.

People said there was a choice of good quality food. People received support with social and recreational activities which they enjoyed. This included growing flowers and vegetables in the garden. We observed staff involving people in a quiz and there was an activities folder detailing the activities provided.

Staff were trained and supervised. Staff said they felt supported and worked well as a team.

The home was comfortable, clean, hygienic and free from any offensive odours.

People could express their views at the residents’ meetings, which were recorded and showed people could contribute to decisions

At the last inspection the service was rated as Good. The inspection report was published on 4 October 2016. The service has changed to Requires Improvement.

Why we inspected: This was a planned, comprehensive inspection. The inspection took place in line with CQC scheduling guidelines for adult social care services.

Enforcement: Action we have told the provider to take is included at the end of this report.

Follow up: We will review the service in line with our methodology for ‘Requires Improvement’ services.

The inspection took place on the 19 July 2016 and it was unannounced.

Offington Park Care Home is a residential care home that is registered to provide accommodation and personal care for up to 24 people. At the time of our inspection, 23 older people were living at the home. People had various needs including dementia and physical disabilities.

Offington Park Care Home is situated in a quiet residential area of Worthing. It is a spacious home, attractively decorated, maintained to a high standard and suitably designed to meet the needs of the people living there. The atmosphere was friendly and inviting. Pictures hung on the walls and ornaments placed in the communal areas added to a homely environment. Bedrooms are spread out over two floors and 13 have en-suite facilities. Communal areas included a lounge area and a dining room. The conservatory area offers an additional space for people to sit or eat their meals and leads into a well-kept patio garden which people told us they enjoyed using. The home has two cats which were appreciated by the people living at the home.

A registered manager was in post and had been registered since October 2010. 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.

People, relatives and visitors told us the home provided a safe service and there was enough staff to meet people’s needs. Staff were able to speak about what action they would take if they had a concern or felt a person was at risk of abuse. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks.

People’s medicines were managed safely and administered by staff who had received specific medicine training. The home followed safe staff recruitment practices and provided a thorough induction process to prepare new staff for their role.

Staff implemented the training they received by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the registered manager.

Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions. They also understood the associated legislation under Deprivation of Liberty Safeguards and how to minimise restrictions to people’s freedom.

People could move freely around the home. They could choose when, where and what they wanted to eat. Additional drinks and snacks were observed being offered in between meals and staff knew people’s preferences.

Staff spoke kindly to people and respected their privacy and dignity. Staff knew people well and had a caring approach.

People received personalised care. Each person, as much as they were able, was involved with their own care plan. Care plans reflected information relevant to each individual and their abilities including people’s emotional and physical health needs. People told us they were happy with the activities that had been organised by the home. There was a complaints policy in place, which was accessible to all people.

People were provided opportunities to give their views about the care they received from the service. People were listened to by the registered manager and the staff team. Relatives were also encouraged to give their feedback on how they viewed the service.

Staff knew their role and their responsibilities including how people should be supported. A range of quality audit processes were in place to measure the overall quality of the service provided to people. The registered manager was committed to providing a high standard of care. The registered manager demonstrated a ‘hands-o

Offington Park Care Home provides long term care and respite care for the elderly. There were 20 people who used the service at the time of our visit. We spoke with four of the people, one visiting relative, the manager and three members of staff. One person who used the service told us they were cared for “Very well indeed.” Another said “It is very good here. Staff are very kind and considerate.”

One person we talked with told us “Staff listen to me and my requests. My care is done in the way I’d want it done.” Another person told us “You get up when you want to. If you want things done your way you just ask them.” Throughout the day we saw that staff explained their actions to people, offered choice and gave people time to respond. This demonstrated that staff practiced the guidance and training they were given in understanding people's preferences and offered them as much choice as possible.

People felt that staff were helpful and kind. One person said, "I receive good care." People told us that staff spoke with them about their care and responded to any concerns or questions they had. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care needs.

Suitable arrangements were in place for the administration of medicines. One person who used the service told us “I get the right medicines, staff deal with that.” Medication arrangements had been updated when shortfalls had been identified.

People we talked with told us that generally there were enough staff on duty to meet their needs. One person told us that they had rung their call bell that morning and staff had attended to them promptly. They told us “If I ring the bell in the night they come quickly as well. I get all the care and help that I need.” It was the view of staff we talked with that there were enough staff on duty to meet the needs of the people at the service.

People had been asked for their views about their care and treatment and were included in discussions about changes to the home. The service had then acted on comments and suggestions they received, for example by providing more activities in the home and outings.

We were informed that there were twenty people living at the Offington Park Care Home. We looked around the building which was clean and free of unpleasant odours. All the rooms were single occupancy with their own toilet and hand basin. There was a lift so people could access the first floor.

During our visit we spoke with four people who used the service and three members of staff including the registered manager and two visitors. We spent time observing how staff interacted and supported people. We saw staff treating people in a sensitive, respectful and professional manner.

One person told us that the staff were very good, another person told us that staff were wonderful and that the food was very good. The visitor’s we spoke with commented that Offington Park was ‘homely’ and that the staff were friendly. One relative told us that they found staff to be attentive and very cheerful and they kept the family informed.

Whilst care plans were in place we saw that not all the files reviewed were person centred and where people needed assistance with personal care there was very little information for staff which detailed how people needed assistance.

We found that Offington Park did not have adequate internal audit processes in place to enable the home monitor compliance to Care Quality Commission regulations. The home was not following their policy and procedure when handling and administering medication which are described ‘as required’.

People told us that they like living at the home. Staff were said to be attentive and kind. The following comment was made:

• ‘It’s wonderful. Everything is done for you. The doctor is called if there are any medical problems.’

• ‘I have everything I need.’

People said that they receive the care and support they need. One person said that he/she was aware that he/she has a care plan. Another person was not aware if he/she had a care plan.

We were told that there are a number of activities for people and that these include entertainment from visiting musicians. People told us how they can choose how to spend their time, such as watching DVDs, reading, writing and using the internet and e mail facilities provided by the service.

People said that the food is very good and that there is a choice. One person said that he/she would like more fruit.

People told us that they are supported to take their medication.

People said that they feel safe in the home.

We were told by people that the home is clean, that they like the environment including their room. People told us that they have been able to bring some of their own belongings to the home and that they use their own telephone in their room.

People said that they are treated well by the staff and that there are enough staff to meet their needs. Staff were said to respond when people ask for help when using the call point in their bedroom.

People said that they are aware of the home’s complaints procedure and that they are asked to give their views about the service.