Park House is a ‘care home’ and rehabilitation service. 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 this inspection.

Park House provides a specialist service for people who require rehabilitation because of an acquired brain injury or a neurological condition. The service provides bespoke rehabilitation programmes for up to 12 people on a long or short term (six week) residential basis, or as an agreed day care package. An interdisciplinary team, based on site, provides extensive support to the service including psychology, physiotherapy, speech and language, and occupational therapy. The service aims to maximise independence and recovery, equipping people with the skills to return home or to a supported environment, achieving rehabilitation goals that promote re-enablement and enhance their quality of life.

A range of accommodation is provided to suit people in all stages of their recovery, from fully supported ensuite bedrooms to bedsits with cooking facilities and independent living flats.

During this inspection, there were 10 people living at the service and one person was receiving day care.

At our last inspection we rated the service good overall, but found that they needed to improve the frequency at which people’s risk assessments were reviewed and updated. At this inspection we found this improvement had been made and further evidence continued to support the overall rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is still rated good:

People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure risks to people were managed safely and these were reviewed regularly.

There were enough staff, with the right training and support, to meet people’s needs and help them to stay safe. Staff provided care and support in a kind and compassionate way. The provider carried out checks on new staff to make sure they were suitable and safe to work at the service, and improvements were being made to strengthen these checks.

Systems were in place to ensure people received their medicines in a safe way and people were protected by the prevention and control of infection.

The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People received care and support that promoted a good quality of life and was delivered in line with current legislation and standards.

People were supported to eat and drink enough. People could select from a choice of food that was freshly prepared by the chef, or make their own meals as part of their programme towards greater independence.

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their healthcare needs. An interdisciplinary team were based on site, providing on-going rehabilitative support.

The building provided people with sufficient accessible individual and communal space, including a garden.

The service acted in line with legislation and guidance regarding seeking people’s consent. People were enabled 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 privacy, dignity, and independence was respected and promoted. They received personalised care and were given opportunities to participate in act

This inspection took place on 8 March 2016. It was unannounced.

Park House is a specialist service for people who require rehabilitation, care and support, as a consequence of an acquired brain injury or a neurological condition. A multidisciplinary team provides extensive support to the service including psychology, speech and language therapy and occupational therapy input. The service can accommodate up to 12 people on a long or short term residential basis. It can also provide transitional support to people in their own homes, or as part of an agreed day care package. During this inspection no one was receiving a home care package but one person was attending the service five days a week for day care.

Only seven people were living at the service. However, this was because the provider had taken the decision to reduce admissions, pending plans to extend the service to include two additional bedrooms, a therapy room, gym and to install a passenger lift.

A registered manager was 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.

Risks were managed so that people’s freedom, choice and control were not restricted more than necessary. However, we did identify some anomalies in terms of how often records and assessments had been reviewed or updated; meaning that we could not be clear if the information was still current and / or met each person's individual assessed needs.

People felt safe living at the service. Staff had been trained to recognise signs of potential abuse and keep people safe.

There were sufficient numbers of suitable staff and the provider carried out robust checks on new staff to make sure they were suitable to work at the service.

Systems were in place to ensure people’s daily medicines were managed in a safe way and that they got their medication when they needed it.

People received effective care from staff who had the right skills and knowledge to meet their needs.

We found that the service worked to the Mental Capacity Act 2005 key principles, which meant that people’s consent was sought in line with legislation and guidance.

People had enough to eat and drink. Support was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

People’s healthcare needs were met. A multidisciplinary team provided regular additional support to the service including psychology, speech and language and occupational therapy input.

Staff were motivated and provided care and support in a caring and meaningful way. They treated people with kindness and compassion and respected their privacy and dignity at all times.

People’s social needs were provided for and they were given opportunities to participate in meaningful activities.

People were given opportunities to be involved in making decisions about their care and support.

People received personalised care that was responsive to their needs. Staff encouraged people to be as independent as possible.

People were supported to raise concerns about the service and these were responded to appropriately.

There were effective management and leadership arrangements in place.

Systems were also in place to monitor the quality of the service provided.

We used a number of different methods to help us understand the experiences of people living at Park House, because some people had complex needs which meant they were not able to talk to us about their experiences. We looked at records and spoke with three people living in the home and four members of staff, including the registered manager. We also spent time observing the care and support provided to five people during lunch.

We found that suitable arrangements were in place for obtaining, and acting in accordance with the consent of people using the service. Although some people did not always communicate with words, they were able to demonstrate their consent clearly through other methods such as actions and physical movement. Staff encouraged everyone to make their own choices and decisions as far as possible.

We found that people were supported to have adequate nutrition and hydration. People we spoke with told us the food provided was good, and that they had enough to eat.

People were supported by sufficient numbers of appropriately skilled staff. One person living in the home told us that the staff genuinely cared about them. Another person told us how staff had helped them to regain their independence.

There were suitable arrangements in place to ensure people had their comments and complaints listened to and acted on effectively.

All the records we looked at during our inspection were also clear, up to date, well maintained and stored securely.

During our visit on 30 August 2012, we spoke with three people living in the home, four members of staff; including the manager and an occupational therapist, who worked closely with the service on a regular basis.

People living in the home spoke positively about the service and told us that the staff treated them well.

We observed some positive interaction between staff and people using the service, which showed that staff understood the needs of the people they were supporting and how best to communicate with them.