This inspection took place on 16 and 20 March 2015. It was an unannounced inspection. The service had met all of the outcomes we inspected against at our last inspection on 12 June 2013.
Madley Park is a care home without nursing on the outskirts of Witney. The home cares for up to 60 older people, who are physically or mentally frail. The home is run by the Orders of St. John Care Homes. On the day of our inspection 57 people were living at the service.
There was a registered manager 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.
Staff and external health professionals told us there were not sufficient staff to meet people’s needs. However, people told us there were enough staff, we observed staff did not appear to be rushed and attended to people promptly. Staffing levels were calculated on the number of people rather than the level of their needs.
People’s medicines were not always administered safely. Some people had their medicine left with them to take which meant staff could not be sure medicines had been taken. Medicines were stored securely and in line with manufacturer’s guidelines.
Records relating to falls analysis were not always complete. Actions had been identified to reduce the risk of falls across the service, but these had not been followed up and progress could not be evidenced.
The registered manager was well respected by staff and created an open and supportive environment for staff to work in, which encouraged improvement. However, some staff told us that senior managers within the provider organisation where not so supportive.
People told us they felt safe. Staff received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service notified the appropriate authorities where concerns relating to abuse were identified and took action to protect people.
Risks to people were managed and reviewed. Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe while maintaining their freedom.
The service ensured staff had the necessary skills to support people through, induction training, ongoing training and regular supervision. Records confirmed staff received appropriate support.
The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA), which governs decision-making on behalf of adults who may not be able to make particular decisions themselves, and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm. Records confirmed people who lacked the capacity to consent were supported in their best interests.
People we spoke with told us that they enjoyed the meals provided. We saw the staff were kind and where appropriate, provided the support people needed with eating and drinking. People made positive comments about the care provided. People’s comments included; “It’s very pleasant” and “It’s as nice as you’ll find for anywhere similar.”
People with complex needs received effective care. The service made appropriate referrals to healthcare professionals and their advice and guidance was followed. This included the district nurse and GP.
The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements. These systems ensured people were protected against the risks of unsafe or inappropriate care. This included complaints. People we spoke with knew how to complain and there was a complaints procedure in place. Records showed complaints were dealt with compassionately and in a timely fashion.