Park House Nursing Care Centre provides care and support for up to 30 elderly people, some who may be living with dementia. At the time of our inspection 23 people were using the service. It is an extended Grade II listed building with accommodation over two floors.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and 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.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff with the correct skill mix on duty to support people with their required needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. 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.

Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions and observed practice.

People were able to make choices about the food and drink they had, and staff gave support if and when required to enable people to access a balanced diet.

People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that people received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. Care plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings below

This inspection was carried out 29 April 2016 and was unannounced. During our last inspection in April 2014 we found that the service met the legal requirements in the areas we looked at.

Park House Nursing Centre is registered with the Care Quality Commission to provide care and accommodation for up to 30 people. Some people may require nursing care and people living at the home may have dementia. At the time of our inspection there were 28 people living at the home.

The home had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 received their medicines as they had been prescribed. An electronic system had been introduced with the aim of improving medicines administration. However the system required further development to enable it to address all situations that could occur in the administration of people’s medicines. During this inspection we Identified that there were some inconsistencies in the stocks of medicines held. Following our inspection the registered manager identified that these were down to errors within the system and introduced manual checks of medicines to identify and resolve any discrepancy speedily.

Staff were aware of the safeguarding process. Personalised risk assessments were in place to reduce the risk of harm to people, as were risk assessments connected to the running of the home, and these were reviewed regularly. Accidents and incidents were recorded and the causes of these analysed so that preventative action could be taken to reduce the number of occurrences.

There were enough skilled, qualified staff to provide for people’s needs. The necessary recruitment and selection processes were in place and the provider had taken steps to ensure that staff were suitable to work with people who lived at the home. They received training to ensure that they had the necessary skills to care for and support the people who lived at the home and were supported by way of supervisions and appraisals.

People’s needs had been assessed before they moved into the home and they had been involved in determining their care needs and the way in which their care was to be delivered. Their consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards were met.

People had a variety of nutritious food and drink available to them. There were freshly made, home cooked meals from a menu that had been devised using people’s likes and dislikes. The cook made regular checks that people were happy with the meals and choices provided. Snacks and fruit were available to people throughout the day.

Staff were kind and caring and protected people’s dignity. Staff treated people with respect and supported people in a way that allowed them to be as independent as possible.

There was an effective complaints system in place. Information was available to people about how they could make a complaint should they need to and the services provided at the home. People were assisted to access other healthcare professionals to maintain their health and well-being.

People and staff were encouraged to attend meetings with the registered manager at which they could discuss aspects of the service and care delivery. People were asked for feedback about the service to enable improvements to be made. There was an effective quality assurance system in place and the provider was an active participant in the day to day running of the service. .

We carried out a follow up inspection of Park House Nursing Care Centre on 1 April 2014 because on our previous inspection we had found that they were not meeting the regulation for assessing the quality of service they provided.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, and the staff supporting them and looking at records.

We found that the home was meeting all areas.

If you wish to see the evidence supporting our summary please read the full report.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. The home had been well maintained. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was always available to provide support to staff. Staff told us that they were ‘able to get things done’ with the support of management.

Is the service effective?

People told us that they were happy with the care that had been delivered and that it was, “A good home” and “Staff made it as comfortable as possible”. People told us that their needs had been met. From a review of care documents and discussions with staff we saw that they had a good understanding of the people’s care and support needs. Staff told us that they received handovers three times during the day which were recorded and discussed; this ensured staff were always kept informed of day to day changes. One person told us that, “Staff are available when you need them”, and that “You can always talk to them”.

Is the service caring?

People were supported by kind and attentive staff. We were told that staff, “Are always cheerful”. We saw that care staff were patient with people and always consulted people before carrying out any care. People told us they were given choices on what they wanted to do in the day and the food they wanted to eat. One person told us that they, “Can’t fault the staff”. Staff we spoke to told us that they all, “Work together” to provide person centred care to people.

Is the service responsive?

People’s needs had been assessed before they moved into the home and care plans had been created and were regularly reviewed and updated to support people in the care that they had been provided with. We saw that staff were aware of people’s needs and preferences and acted in accordance with their wishes.

Is the service well-led?

Staff told us that they enjoyed caring for the people who lived in the home and that they worked hard to make the home a, “Happy place” for the people to live. Previously the home did not have robust quality assurance processes in place. We saw that the manager had now put in place processes that ensured the quality was regularly monitored. People had recently completed a customer satisfaction survey and we saw that the results of the survey showed that people were generally happy with the service being provided. Staff told us they were clear about their roles and responsibilities and that management was “Very supportive and approachable”.

We carried out an inspection of Park House Nursing Care Centre from 06.20hrs, on 18 November 2013. During the inspection we spoke with the provider, the registered manager, four night staff, five day staff, the administrator and the cook. We also spoke with seven of the 29 people living at Park House Nursing Centre and two visitors to the home. Some people were not able to speak with us; we therefore observed the interactions between them and the staff to understand their experiences.

We saw that the staff cared for people in a respectful way and had been provided with the necessary training to ensure they had the experience to meet people's assessed needs. Staff told us what they would do if they felt people were not being cared for correctly. People who use the service told us they felt safe living at Park House Nursing Care Centre. One person said, “Everyone is lovely.” Another said, "I like some of the staff more than others, but everyone of them is kind."

Everyone we spoke with was complimentary about the standard of food in the home. One person said, "I like everything but if I didn't the cook would come up with something special for me." We observed breakfast and lunch. Breakfast was provided to people as they wanted it and lunch was served at 12.15. We were told a meal could be kept if someone did not want it at this time.