Hinckley Park Nursing Home

Hinckley Park Nursing Home provides accommodation for up to a maximum of 40 older people, including people that need support because of their physical frailty and those who need professional on-site nursing care because of their medical condition. There were 32 people in residence when we inspected.

The home is purpose built and made up of two floors, with lift access to the upper floor. A landscaped garden is available for people to enjoy.

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 on-going 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.

The service met all relevant fundamental standards related to staff recruitment, training and the care people received. People’s care was regularly reviewed with them so they received the timely care they needed. 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 were friendly, kind and compassionate. They had insight into people’s capabilities and they respected people's preferences for the way they liked to receive their care.

People’s healthcare needs were met. They received timely medical attention, including nursing care, when they needed it and they also had access to external healthcare professionals, such as GPs, when this was required. Medicines were safely managed.

People were supported to have a balanced diet. They had enough to eat and drink and said they were provided with choices to suit their tastes and appetite. We received varied feedback regarding the quality of the food; a few people said the quality of the food needed to improve whilst others said they enjoyed their meals and had no complaints.

A few people said the quality of the food needed to improve whilst others said they enjoyed their meals and had no complaints about its quality.

The premises and equipment used to provide people with the care they needed were appropriately maintained throughout to ensure their safety. Systems were in place to ensure the premises were kept clean and hygienic so that people were protected by the prevention and control of infection.

The provider and registered manager led staff by example and enabled the staff team to deliver individualised care that consistently achieved good outcomes for all people using the service. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong so that the quality of care across the service was improved.

Hinckley Park Nursing Home provides care for up to 35 older people. At the time of our inspection 34 people were using the service. Accommodation is on two floors, accessible by stairs and a lift. People’s rooms have an en-suite and are spacious. Facilities include communal lounges and dining areas and an enclosed garden. Since our last inspection in September 2014 the home had undergone extensive internal refurbishment.

The service was managed by a manager who was in the process of applying to be a registered manager. 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 were protected from abuse. Staff understood their responsibilities to identify and report any sign of abuse using the provider’s safeguarding procedures. Staff knew they could report any concerns about people’s safety directly to the Care Quality Commission. People were protected from avoidable harm through risk assessments. These included information for staff about how to support people safely and without undue restrictions.

Staffing deployment was based on needs of people using the service. If people’s needs increased, additional staff were deployed. Relatives of people using the service felt that staff were `stretched’ but this coincided with a period when the service was experiencing higher than normal staff absences. Additional staff were being recruited. The provider’s recruitment procedures ensured as far as possible that only people suited to work at Hinckley Park Nursing Home were employed.

The provider’s arrangements for the storage of medicines were safe. Only staff who successfully completed training in management of medicines supported people with their medicines.

People using the service were supported by staff with the right skills and knowledge. Staff were supported through effective training and supervision. Staff understood and practised their responsibilities under the Mental Capacity Act 2005. They sought people‘s consent before they provided care and support. No person had restrictions on their liberty unless it had been authorised under the Deprivation of Liberty Safeguards.

People were supported with their nutritional needs. Not all staff completed fluid intake records accurately, but action was being taken to improve completion of those records.. People had a choice of nutritious food and were protected from the risks of malnutrition and dehydration. People were supported to access health services when they needed them. The service arranged for health professionals to visit the service to attend to people’s health needs.

Staff developed caring relationships with people using the service. They were able to do this because they understood people’s needs and their life stories. Staff were attentive to people’s needs and supported them to be comfortable.

People using the service and their relatives had opportunities to be involved in decisions about their care and support. They had access to information about the service and their individual care plans.

Staff treated people with dignity and respect. People were able to spend their time the way they wanted and their choices were respected. People were able to spend private time alone or with relatives in their rooms.

People’s care plans were focused on how their individual needs were met. Staff referred to people’s care plans and understood their needs. People had opportunities to be involved in reviews of their care plans and to provide feedback about their care and support.

People using the service and their relatives had access to a complaints procedure.

The service was managed by a person who had applied to be a registered manager. They understood the CQC registration requirements.

The provider’s quality assurance procedures kept up to date with changes in legislation and were used to monitor and assess the service’s compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Those procedures were used to drive improvement at the service.

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

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

Is the service safe?

We saw that staff treated people with dignity and respect and as individuals. Staff respected people's choices about how they wanted to be supported. Staff spoke politely to people, offered encouragement and explained why they supported them the way they did.

Relatives we spoke with told us their family members were safe at the home.

At the time of our inspection there were two safeguarding investigations of incidents that had occurred in June 2014. The investigations had not been completed, but the provider had already identified areas that required improvement. Improvements had been made to protect people from harm.

People told us that they felt enough staff were usually on duty. Staff rotas had ensured that two nurses and seven care workers were on duty during the day. That resulted in a ratio of one staff to three people who used the service

Staff we spoke with understood how to identify and report signs of abuse. Staff also knew how to report accidents and injuries. Procedures were in place for managers and staff to learn from events such as accidents and incidents. The provider had acted quickly and effectively after two safeguarding incidents and in a way that prevented similar incidents happening again. That showed the provider placed a high priority on people's safety.

Staff we spoke with had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This is legislation that protects vulnerable people who are or may become deprived of their liberty through the use of restraint, restriction of movement and control. This showed that staff understood how people's safety was respected and their best interests taken into account.

Is the service effective?

People's health and care needs were assessed with them or their relatives. Care plans included details of people's needs and information about how people were supported with their needs. Care plans and records we looked at showed that people had received the support they required.

Care records we looked at showed that people had been supported with their personal care routines. People had been supported with their health and nursing needs because the service worked closely with providers of those services. We found that staff monitored people's health and made referrals to the appropriate specialists when required.

Is the service caring?

People told us they were well looked after. We saw that staff showed patience and gave encouragement when they supported people. Staff used people's preferred names when they spoke with them. People we spoke with were complimentary about the staff.

People took part in social activities that involved other people and had also been supported to enjoy activities that were of particular interest to them.

We found that the service understood people's individual needs and had supported people in a caring way.

Is the service responsive?

People told us they were well looked after. They told us they had been supported with their personal care and health needs. The service had organised meetings for people who used the service to which relatives had been invited. People who used the service and relatives told us that they knew how they could make suggestions or raise concerns. They added that they were confident they would be listened to.

Is the service well-led?

The service had a system for monitoring the quality of service. This operated at two levels. The acting manager carried out a series of scheduled checks that monitored the quality of care provided. They reported to an area manager who carried out regular inspections of the service. The provider's monitoring procedures were robust and set high expectations concerning the quality of care.

People who used the service, their relatives and staff were asked for the views and their views were acted upon.

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

Is the service safe?

People were treated with respect and dignity by the staff. The home had staff who had been trained to be dignity champions and that had benefited people who used the service. We saw that staff supported people with dignity and respect and were attentive to people's needs. The registered manager told us that they had sought to help staff practice dignity in care. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

People told us they felt safe. They told us, "I feel safe here. There are always staff about. Staff check me at night to see that I am alright. It's nice to have people we can rely on."

Systems were in place to make sure that the registered manager and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations, This reduced the risks to people and helped the service to continually improve. The provider had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). These are safeguards that protect people from unlawful restraint. The provider had not needed to make any DoLS applications. The registered manager understood when an application should be made and how to submit one. The registered manager was aware of a recent ruling in the Supreme Court about deprivation of liberty. That showed that the service kept up to date with very important developments in adult social care. We found that people were safeguarded as required.

The service was safe, clean and hygienic. The provider employed ancillary staff who cleaned the home to a good standard. Cleaning and washing facilities were properly provided and maintained.

The registered manager set the staff rotas within guidelines set by the provider's head office. The registered manager took people's care needs and dependency levels into account when making decisions about the numbers, qualifications, skills and experience of staff required. This helped to ensure that people's needs were met by sufficient staff being on duty because the registered manager was not constrained by their head office guidelines about staffing levels. .

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access independent advice and assistance..

People's health and care needs were assessed with them. They were involved in reviews of their care plans. Dietary, medication, mobility and equipment needs had been identified in care plans. We saw that staff used equipment correctly when they supported people with transfers and mobility. People who required wheelchairs had their own which protected them from risk of cross contamination.

People were able to move around the home freely and safely because the home was well laid out and adapted to meet the needs of people with physical impairments.

The service had safe and effective arrangements for ensuring that people who required medication received the right medication at the right time.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers gave assurance and encouragement when supporting people. People commented, "The staff are good. I can't fault the staff. they help me with my mobility. Staff are always there for me.". A relative of one person said, "Sometimes people have to wait too long for staff." Another person who used the service told us, "There are always staff about.".

People who used the service and their relatives were able to provide feedback to the provider about their experience of the service. The provider acted upon what people said.

Is the service responsive?

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People took part in a range of activities in and outside the service. One to one and group activities were provided. People had taken part in activities in the community. The registered manager told us that they were planning to make more use of the service's minibus as the weather improved.

People knew how to make a complaint or raise concerns if they were unhappy. No complaints had been made, but people could be confident that complaints would be investigated and acted upon.

Is the service well led?

The service had an effective quality assurance system that identified shortfalls and good practice. Shortfalls were promptly addressed. As a result the quality of the service was continually improving.

Staff we spoke with had a good understanding of the ethos of the home. This helped to ensure that people received a good quality service at all times. The management team were approachable and accessible.

Most of the people we spoke with told us that they were satisfied with the meals provided. One told us, “The food is good, there is a good variety and you get a good choice.” Arrangements for measuring if there were any risks associated with people’s nutrition were unreliable.

The home was kept clean and tidy and a regular audit was carried out to check for any possible risks of infection or poor hygiene. One of the people we spoke with said, “It’s all kept lovely and clean. The staff are very good, they wear gloves and aprons when they are helping me with washing and showering.”

There were concerns relating to the management of medicines. Arrangements for managing people’s PRN (taken as required) medication needed to improve and procedures for the disposal of medicines were not being followed.

Effective recruitment processes were followed when new staff were appointed and appropriate checks carried out before they commenced their new roles.

Staff participated in regular training to help ensure that they had appropriate skills and knowledge.

Care plans and assessments were kept up to date and explained people’s individual needs and wishes. Staff were familiar with people’s needs. They demonstrated an awareness of how best to provide the care and support that each person required.