This inspection took place on 12 and 18 September 2017 and was unannounced. A previous inspection undertaken in December 2016 found there two breaches of legal requirements.

Wilkinson Park is registered to provide accommodation, personal care and support for up to 21 adults with learning difficulties. The home is subdivided into a main house, a courtyard semi-independent living area and two cottages attached to the home, where people also live on a semi-independent basis. At the time of the inspection there were 17 people using the service.

The home had a registered manager who had been registered with the Care Quality Commission since August 2017. This registered manager had left the home approximately three weeks prior to the inspection, but had not cancelled their registration at the time of the inspection. An acting manager had been appointed and had been in post for two weeks. A registered manager is a person who has registered with the 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. The acting manager was supported in their role by regular visits from the provider’s Head of home operations. Both individuals were in attendance and supported the inspection over the two days.

The service had previously been in organisational safeguarding, but had worked closely with the local safeguarding adults team and had recently come out of this overarching safeguarding process. The provider had dealt with recent safeguarding issues appropriately.

There had been previous concerns with regard to staffing at the home and in particular the high use of agency staff. At this inspection we saw the provider had taken action to address this issue. Several new staff had been recruited and people and staff told us this had had a beneficial effect on the service. Appropriate recruitment processes and checks had been followed.

Checks on the safety and security of the premises were undertaken and safety certificates for gas, electricity and small electrical appliances were in place. Checks related to fire safety were also undertaken. Medicines at the home were dealt with safely and appropriately. The provider had introduced a new electronic medicines system, which staff said made the administration of medicines easier and safer.

The home was generally clean and tidy. An outside contractor was currently used twice a week to thoroughly clean the home until full time domestic support could be appointed. A basic infection control audit had been completed. Some people raised issue about odours in the home at times, potentially linked to ongoing issue with drainage. The handyman told us a solution was being considered.

Staff told us they had access to a range of training and new staff had completed a detailed induction programme before starting work at the home. Training records indicated staff were up to date with mandatory training areas. We had previously found issues with annual appraisals not being undertaken at the home. At this inspection we found the issue had been addressed. Staff confirmed they had regular appraisals and supervision and support sessions.

People told us they found the food acceptable, although a number suggested the variety of dishes could be increased. Some people told us they were also able to go shopping and were supported to prepare their own food, where they lived in the semi-independent accommodation. People continued to have access to health care professionals to help maintain their wellbeing.

The acting manager confirmed appropriate assessments and applications had been made, where people met the criteria laid down in the Deprivation of Liberty Safeguards (DoLS) guidance, and records confirmed this. They told us people living at the home had the capacity to make the majority of decisions. Where ther

We carried out an unannounced focussed inspection of the home on Tuesday 6 December 2016. This was because we had received concerning information about the home and the wider management of the provider’s services. At this inspection we looked at three of the five key questions we ask when we inspect a service: Is the service safe? Is the service effective? And Is the service well-led?

This report only covers our findings in relation to these domains. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Wilkinson Park’ on our website at www.cqc.org.uk’

We carried out a comprehensive inspection of the service in June 2016. The overall rating for the home at this time was 'Requires Improvement.’ We found a breach in Regulation 18 relating to staff support and made recommendations regarding revising the tool used to determine staffing levels and also that an infection control audit should be undertaken. The provider wrote to us and told us what action they were going to take to address the breaches and said the matters would be addressed bu August 2017. There was no registered manager in post at the June 2016 inspection.

Wilkinson Park is registered to provide accommodation, personal care and support for up to 21 adults with learning difficulties. The home is subdivided into a main house and integral semi-independent living area. There are two cottages attached to the home, where people also lived on a semi-independent basis. At the time of the inspection there were 17 people living at the service.

At the time of this inspection there continued to be no registered manager registered at the location. 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. The day to day running of the location was carried out by an acting manager who was not available on the day of the inspection.

Safeguarding records were not well kept or completed and there were discrepancies between notifications received by the CQC and copies of safeguarding alerts sent to the local authority. We could not be certain that safeguarding matters were managed appropriately.

There was high use of agency staff at the home, although people living at the home told us most of the agency staff were very good at supporting them. Some shifts had more agency staff than permanent staff. The Head of homes told us some new staff had been recruited but there was still a shortfall in support workers at the home. A new deputy manager was awaiting references and DBS checks. Interviews for a registered manager had not been successful. People told us staffing had improved although the use of agency staff still limited their access to the community.

A recommendation made at the last inspection, to review the dependency tool used to determine staffing levels at the home, had not been undertaken. The Head of homes said this was because of the lack of a permanent manager.

Accidents and incidents were recorded, but had not been analysed to identify any trends or issues. Actions listed to prevent further accidents were not always detailed or appropriate.

Checks on fire equipment and safety systems at the home had been undertaken and recorded. Staff recently recruited had been subject to a proper interview and recruitment process, including the taking up of references and DBS checks.

Medicines were managed appropriately and there were no gaps in the recording of medicines at the time of the inspection. Checks were maintained on the stock of medicines at the home.

A recommendation made at the last inspection, to undertake an infection control audit, had not been followed, to date. The Head of homes said this was because of the change in managers at the

This inspection took place on 24 and 27 June 2016. The inspection on the 24 June 2016 was unannounced. This meant the provider was not aware we intended to visit the service on this date.

Wilkinson Park is registered to provide accommodation, personal care and support for up to 21 adults with learning difficulties. The home is subdivided into a main house and integral semi-independent living area. There are two cottages attached to the home, where people also lived on a semi-independent basis. At the time of the inspection there were 16 people living at the service.

At the time of the inspection there was no registered manager registered at the location. This was because the previous manager had recently retired. 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. The day to day running of the location was carried out by a service manager, who would report to the registered manager.

At the previous inspection in March and April 2015 we found two breaches in regulations. Some windows at the home did not have appropriate window restrictors in place and care plans were not always clear or dated appropriately to show when they had been reviewed. The provider wrote to us and told us these matters would be dealt with by June 2015. At this inspection we saw care plans had been updated with clear information to help staff support people and that reviews took place regularly. We also saw that window restrictors had been fitted throughout the home. A range of checks were also undertaken on other safety equipment and systems, such as fire and water systems.

People and staff told us it would be helpful to have more staff and that sometimes it was difficult to participate in activities because there were not enough experienced staff on duty. The provider had a dependency tool in place to help determine staffing levels. However, this did not always take into account the specific needs of the home’s rural location. We have made a recommendation this is reviewed.

The home was clean and tidy and appropriate personal protective equipment was available throughout the building. We found action to support one person using a commode was not in line with national guidance. We have recommended a review of infection control procedures at the home.

Appropriate safeguarding procedures were in place to help protect people from abuse. The provider had in place systems to ensure staff recruited to the service were relevantly experienced. Risks related to supporting people with care and the running of the home were assessed and action taken to minimise them. Medicines at the home were managed effectively.

Staff at the home had access to a range of training and development opportunities. Staff told us they had regular supervision by managers or senior staff. Annual appraisals had not been undertaken, some for as long as two and a half years.

The acting manager confirmed some people were subject to Deprivation of Liberty orders under the Mental Capacity Act (2005). We saw assessments and applications in relation to DoLS had been undertaken. People who were subject to other legal restrictions also had these matters reviewed. Staff had received training in managing challenging behaviour and had a good understanding of dealing with these situations. People were supported to make choices and assisted to maintain good health and wellbeing.

People told us food at the home was good and they could request particular items if they wished. Some people were supported to go shopping and cook their own meals. Individual rooms were decorated to personal taste, although the decoration in some of the public areas were in need of refreshing.

People told us they were happy with the staff

We spoke to five people. People told us they were happy with the support they received. One person said, “I am really happy with the changes. My room has been decorated and I have a new carpet. The cleaner comes in so it is always clean.”

We looked at the arrangements in place for infection control as we had concerns about this at our last visit. We found improvements had been made and we concluded people were cared for in a clean, hygienic environment.

We looked around the environment in which people were cared for and the equipment available to support them in their daily lives. We found the provider had taken action to address the issues identified at the last inspection. We were satisfied people were protected from the risks of unsafe or unsuitable premises.

We spoke to three people and two relatives. People told us they were happy with the support they received. We spoke with two relatives who said, “The staff do a good job and we have always been happy with the care and support provided.”

We found people’s care and treatment was planned and delivered in line with their individual care plan.

We concluded people were provided with adequate nutrition and hydration.

We found people were not always cared for in a clean, hygienic environment.

We saw the provider had not protected people, staff and visitors against the risks of unsafe or unsuitable premises.

There were effective recruitment and selection processes in place.

Staff records and other records relevant to the management of the service were accurate and fit for purpose.

People told us they were involved in making decisions about their care and lifestyle. They said they liked living at Wilkinson Park and were satisfied they got a good service that suited their individual needs. One person said, “I like it here, I enjoy the activities especially fishing and I get to go out quite a bit. The staff are all right, I can talk to them if I am worried about anything. They take what I say seriously.” Another person said the food was good and they got enough to eat. They said there was always something to do and they went out shopping every week. People told us they enjoyed the college courses and that they were working towards national qualifications and that was good. They said they liked their accommodation. Another person said the change of provider had not really affected their daily life and the staff supported them well. People also told us they felt safe and were able to voice their opinions and concerns.

This inspection took place on 31 March and 1 April 2015 and was announced. A previous inspection undertaken in September 2013 found there were no breaches of legal requirements.

Wilkinson Park is registered to provide accommodation, personal care and support for up to 21 adults with learning difficulties. The home is subdivided into a main house and semi-independent living area and two cottages attached to the home, where people also live on a semi-independent basis.

The home had a registered manager who had been registered with the Care Quality Commission since February 2014. A registered manager is a person who has registered with the 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.

The provider had in place a safeguarding policy and had dealt with recent safeguarding issues appropriately. Staff were aware of safeguarding issues, had undertaken training in this area and told us they would report any concerns of potential abuse. We found some issues with the maintenance of the premises. We noted window restrictors had not been fitted to upper floor windows, although this had been highlighted in a manager’s review report and an action requested by the fire service in January 2014 had not been completed. Action was taken during our inspection by the provider to deal with these issues. Medicines at the home were dealt with safely and appropriately.

Appropriate staffing levels were maintained to support the developing needs of people living at the home. Proper recruitment procedures and checks were in place to ensure staff employed at the home had the relevant skills and experience to support people. Staff told us they had access to a range of training and had completed a detailed induction programme before starting work at the home. They told us, and records confirmed they had regular supervision sessions and an annual appraisal.

People told us they enjoyed the food and drink at the home and said it had improved recently with the appointment of a trained cook. People told us they were also able to go shopping and cook their own food when they lived in the semi-independent accommodation.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. The registered manager confirmed that appropriate assessments and applications had been made, where people met the criteria laid down in the DoLS guidance. She told us a number of people had been assessed and she was awaiting final decisions as to whether DoLS legislation applied to their circumstances. Staff were aware of the need for best interests meetings to take place where decisions needed to be made and people did not have capacity to make their own decisions.

We found the decoration in communal areas was in need of updating. The registered manager told us there was a planned programme to refresh the home over the next few months.

People told us they were happy with the care provided. We observed staff treated people with kindness and respect. They showed a genuine interest in them as individuals, asking people what they were planning to do and discussing interests with them such as a forthcoming birthday party and recent football results. People had access to health care professionals to help maintain their wellbeing. Professionals told us the service and support provided was generally good, although felt people would benefit from staff having additional skills in some areas. People said their dignity was respected and staff knocked on doors or valued their privacy.

People had individualised care plans that addressed their identified needs. However, we found that reviews of care plans were not detailed and did not always reflect the current situation with some people who lived at the home. People talked enthusiastically about activities they participated in. They told us they were part of local indoor bowls teams, went fishing and enjoyed breeding budgies at the home. Some people told us they would like some additional activities that stretched them more, such as formal qualifications. There had been no formal complaints in the last year and internal complaints were addressed appropriately.

The registered manager showed us records confirming regular checks and audits were carried out at the home. Staff were positive about the leadership of the home and felt well supported by management. People and staff all talked about the positive atmosphere at the home and how they enjoyed working and being there. People who used the service told us they valued the support they received from staff.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to premises and equipment and good governance. You can see what action we told the provider to take at the back of this report.