Archived: Offington Park Care Home

Offington Park Care Home is situated in Offington, Worthing, West Sussex. It is a residential 'care home' for up to 24 older people, some of whom are living with dementia. At the time of the inspection there were 17 people living at the home.

People’s experience of using this service and what we found

People told us they were happy at the home and with the care they received from staff. One person said, “I am very happy here, this is my home and I like it. I find all the staff to be good, they are very good in my view. They look after me very well. I like to be independent and they support that.”

People told us they felt safe living at the home, and relatives said they felt their loved ones were safely cared for. Risks to people’s health and wellbeing were assessed and mitigated by staff who knew them well. People were protected from the risk of abuse.

People were supported by enough, qualified staff who had received training specific to the needs of the people they cared for. Staff ensured that people were protected from infection throughout the COVID-19 pandemic. Training and guidance had been provided to enable staff to do this. One relative said, “The most important skill is being caring and patient and they all have that, that’s for sure.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they were involved in their care and staff and management sought their views and opinions. The provider and manager continuously looked to improve the service to achieve better outcomes for people. People, staff and relatives spoke highly of the manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 25 September 2020).

Why we inspected

This was a planned inspection based on the previous rating. We completed a focused inspection to look at whether the provider had made improvements to the areas highlighted in their previous inspections. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Offington Park Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Offington Park Care Home is situated in Offington, Worthing, West Sussex. It is a residential ‘care home’ for up to 24 older people, some of whom are living with dementia. At the time of the inspection there were 19 people living at the home.

People’s experience of using this service and what we found

Staff had worked to ensure people were safe from the COVID-19 pandemic. They had received guidance and support informing them of how to keep themselves and others safe. We found three members of staff did not always use personal protective equipment (PPE) in accordance with the provider’s or government’s guidance. Medicines had not always been provided according to prescribing instructions for one person. Medicines were sometimes out of stock and two people had not received their medicines. Once these findings were fed back to the provider, they acted immediately to ensure improvements were made.

People told us they were happy, secure and safe at the home. Staff ensured people were provided with care that met their assessed needs and minimised risks. Lessons had been learned from previous incidents to help ensure people received safe care following falls. People were protected from the risk of abuse. Staff worked together to help ensure there was sufficient staff to meet people’s needs during the COVID-19 pandemic.

The manager and provider had acted to help improve the care people received. Systems and processes had been introduced to help provide greater oversight of people’s care. This provided assurances people were receiving safe and appropriate care to meet their assessed needs. Similar themes, to those that were found as part of our inspection, had been identified by the manager, provider and an external consultant. This provided confidence that they had identified where further improvements were needed and were acting to ensure these were made. The provider had made improvements and was no longer in breach of any regulations. Staff, people and relatives were involved in decisions that affected people’s care and the running of the home. Staff told us they felt well-supported, listened to and value. People told us they felt well-cared for and that staff were kind and compassionate. One person told us, “This care home is lovely and the staff are all so nice.”

Rating at last inspection and update

The last overall rating for the home was requires improvement (Supplementary report published 7 April 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of the regulations.

Why we inspected

We carried out an announced focused inspection on 25 September 2020. We contacted relatives on 29 September 2020. We gave the manager and provider 48 hours’ notice of the inspection to enable CQC and the manager to consider any infection prevention and control protocols due to the COVID-19 pandemic.

We looked at infection prevention and control measures under the Safe Key Question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We undertook this focused inspection to check they had followed their action plan and to confirm they now meet legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led.

The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the home remains rated as Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Offington Park Care Home on our website at www.cqc.org.uk

In February 2020, the provider notified us of an unexpected death of a person who had sustained a head injury. This incident is subject to ongoing investigation. As a result, this inspection did not examine the circumstances of the incident. However, we looked at how the provider had learned lessons from the incident to help ensure people’s safety.

Follow-up

We will continue to monitor the intelligence we receive about the home until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Offington Park Care Home is situated in Offington, Worthing, West Sussex. It is a residential ‘care home’ for up to 24 older people some of whom are living with dementia. At the time of the inspection there were 20 people living in the home.

People’s experience of using this service and what we found

Risks were not always well-managed. There was a lack of oversight of medicines management and one person had not had their medicines administered according to prescribing guidance. There was insufficient monitoring and action taken when one person was at risk of malnutrition.

The home did not have a registered manager and there was insufficient oversight. Quality assurance processes had failed to identify the concerns that were found as part of the inspection. Systems were not always used to their best effect to ensure people were receiving appropriate care to meet their assessed needs. Staff were not always provided with accurate or consistent guidance to inform their practice. Records were not always well-maintained. The provider had not always complied with conditions of their registration as there was no registered manager and they had failed to inform us of this.

People were not always supported to have maximum choice and control of their lives and staff had not always supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider was responsive when concerns or suggestions for improvement were raised and took immediate action to reduce risks and improve the oversight and monitoring of people’s needs.

People were protected from abuse and improper treatment. The provider and staff worked in partnership with people, their relatives and external healthcare professionals. Changes to practice had taken place to ensure lessons were learned when there were risks to one person’s safety. People were protected from the spread of infection. There was enough staff to meet people’s needs.

People were happy and told us they were fond of the small, consistent staff team who they thought of as ‘friends.’ There was a warm, homely and welcoming atmosphere and people were treated in a respectful way and their privacy and dignity was maintained. People were involved in their care and were supported to retain their abilities and skills; their independence was promoted. One person told us, “They’re very good and everybody is very helpful. They’ve got time for you and they chat with you.”

Staff were responsive to people’s needs and adapted their support to ensure these were met. People were provided with support with their emotional and social needs and were able to maintain their interests. People told us they had enough to occupy their time and they enjoyed the activities and interactions that were provided. People and relatives told us they were comfortable raising concerns with staff and they had confidence that if they raised concerns these would be listened to and acted on. People were supported to plan for and receive appropriate end of life care.

People’s needs were assessed in accordance with best practice guidance. There was a coordinated approach to the care people received to help maintain their health and to ensure they had access to external healthcare professionals if they became unwell. People had enough to eat and drink and told us that they liked the food that was provided.

Shortly after the inspection, the provider notified us of an incident that had occurred. We are investigating the incident outside of the inspection process and will take any appropriate action.

Rating at last inspection and update

The last rating for this home was Requires Improvement. (Published 7 March 2019). There were breaches of regulation in relation to safety and the leadership and management of the home. At this inspection, we continued to have concerns and we found the provider was still in breach of regulations. The home remains rated Requires Improvement and has now been rated Requires Improvement at the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified continued breaches in relation to people’s safety and the leadership and management of the home. We found two new breaches as the provider had not complied with the requirement of their registration. There was no registered manager and they had failed to inform us of this. Please see the action we have told the registered manager to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow-up

We will continue to monitor the intelligence we receive about this home. We will request an action plan from the provider to understand what they will do to improve the standards of safety and governance. We plan to inspect in line with our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Offington Park Care Home on our website at www.cqc.org.uk.

Offington Park Care Home is a ‘care home.’ The home is registered to provide accommodation and personal care for up to 24 older people. At the time of the inspection there were 22 people living at the home.

People’s experience of using this service:

The provider had not followed the West Sussex Fire and Rescue Service’s advice. There were no records of weekly testing of the fire alarms and monthly tests of the emergency lighting. The smoke detector system had not been extended to the office which was also advised by the fire and rescue service. Risks assessments were not carried out when bed rails were used to prevent people falling out of their bed.

Whilst people said their care needs were discussed with them, there was a lack of records that people had consented to care practices which restricted their liberty. The provider made applications to deprive people of their liberty for reasons of safety; these are called Deprivation of Liberty Safeguards (DoLS). However, the provider had not assessed whether or not people had capacity to consent to these restrictions before applying for DoLS.

The provider had introduced a new computerised care plan system. These computerised assessment and care plans varied greatly in detail. Some sections were incomplete whereas others were completed well.

The provider’s system to assess, monitor and improve the quality and safety of services was not effective. The system of checks had not monitored whether improvements had been completed. This included the advice of the fire and rescue services and routine fire safety checks. The provider used audits which had identified improvements were needed in the assessments and care plans but these were not fully actioned. At the time of the inspection, the registered manager was not available and the provider had difficulty locating some records. For example, the provider said surveys were used to check people’s views about the service but these could not be located.

People and their relatives said they were satisfied with the standard of care provided. For example, one relative said, “I can’t fault it.” People said they received individualised care and support which they had discussed with staff. Relatives and people said the staff were friendly and treated people with respect. One person, for example, said, “It’s marvellous. I get a lot of attention. The staff are very nice. Kind. They do all they can to help you. They always come when you ring the bell.” Staff demonstrated they promoted values of treating people with respect and dignity. Staff said they treated people as they would treat a family member. Staff were observed to talk to people with respect and in a polite and friendly manner.

People said there was a choice of good quality food. People received support with social and recreational activities which they enjoyed. This included growing flowers and vegetables in the garden. We observed staff involving people in a quiz and there was an activities folder detailing the activities provided.

Staff were trained and supervised. Staff said they felt supported and worked well as a team.

The home was comfortable, clean, hygienic and free from any offensive odours.

People could express their views at the residents’ meetings, which were recorded and showed people could contribute to decisions

At the last inspection the service was rated as Good. The inspection report was published on 4 October 2016. The service has changed to Requires Improvement.

Why we inspected: This was a planned, comprehensive inspection. The inspection took place in line with CQC scheduling guidelines for adult social care services.

Enforcement: Action we have told the provider to take is included at the end of this report.

Follow up: We will review the service in line with our methodology for ‘Requires Improvement’ services.

Offington Park Care Home is a residential care home that is registered to provide accommodation and personal care for up to 24 people. At the time of our inspection, 23 older people were living at the home. People had various needs including dementia and physical disabilities.

Offington Park Care Home is situated in a quiet residential area of Worthing. It is a spacious home, attractively decorated, maintained to a high standard and suitably designed to meet the needs of the people living there. The atmosphere was friendly and inviting. Pictures hung on the walls and ornaments placed in the communal areas added to a homely environment. Bedrooms are spread out over two floors and 13 have en-suite facilities. Communal areas included a lounge area and a dining room. The conservatory area offers an additional space for people to sit or eat their meals and leads into a well-kept patio garden which people told us they enjoyed using. The home has two cats which were appreciated by the people living at the home.

A registered manager was in post and had been registered since October 2010. 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, relatives and visitors told us the home provided a safe service and there was enough staff to meet people’s needs. Staff were able to speak about what action they would take if they had a concern or felt a person was at risk of abuse. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks.

People’s medicines were managed safely and administered by staff who had received specific medicine training. The home followed safe staff recruitment practices and provided a thorough induction process to prepare new staff for their role.

Staff implemented the training they received by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the registered manager.

Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions. They also understood the associated legislation under Deprivation of Liberty Safeguards and how to minimise restrictions to people’s freedom.

People could move freely around the home. They could choose when, where and what they wanted to eat. Additional drinks and snacks were observed being offered in between meals and staff knew people’s preferences.

Staff spoke kindly to people and respected their privacy and dignity. Staff knew people well and had a caring approach.

People received personalised care. Each person, as much as they were able, was involved with their own care plan. Care plans reflected information relevant to each individual and their abilities including people’s emotional and physical health needs. People told us they were happy with the activities that had been organised by the home. There was a complaints policy in place, which was accessible to all people.

People were provided opportunities to give their views about the care they received from the service. People were listened to by the registered manager and the staff team. Relatives were also encouraged to give their feedback on how they viewed the service.

Staff knew their role and their responsibilities including how people should be supported. A range of quality audit processes were in place to measure the overall quality of the service provided to people. The registered manager was committed to providing a high standard of care. The registered manager demonstrated a ‘hands-on’ approach and knew people well.

One person we talked with told us 'Staff listen to me and my requests. My care is done in the way I'd want it done.' Another person told us 'You get up when you want to. If you want things done your way you just ask them.' Throughout the day we saw that staff explained their actions to people, offered choice and gave people time to respond. This demonstrated that staff practiced the guidance and training they were given in understanding people's preferences and offered them as much choice as possible.

People felt that staff were helpful and kind. One person said, "I receive good care." People told us that staff spoke with them about their care and responded to any concerns or questions they had. People's needs were assessed and care and treatment was planned and delivered in line with their individual care needs.

Suitable arrangements were in place for the administration of medicines. One person who used the service told us 'I get the right medicines, staff deal with that.' Medication arrangements had been updated when shortfalls had been identified.

People we talked with told us that generally there were enough staff on duty to meet their needs. One person told us that they had rung their call bell that morning and staff had attended to them promptly. They told us 'If I ring the bell in the night they come quickly as well. I get all the care and help that I need.' It was the view of staff we talked with that there were enough staff on duty to meet the needs of the people at the service.

People had been asked for their views about their care and treatment and were included in discussions about changes to the home. The service had then acted on comments and suggestions they received, for example by providing more activities in the home and outings.

During our visit we spoke with four people who used the service and three members of staff including the registered manager and two visitors. We spent time observing how staff interacted and supported people. We saw staff treating people in a sensitive, respectful and professional manner.

One person told us that the staff were very good, another person told us that staff were wonderful and that the food was very good. The visitor's we spoke with commented that Offington Park was 'homely' and that the staff were friendly. One relative told us that they found staff to be attentive and very cheerful and they kept the family informed.

Whilst care plans were in place we saw that not all the files reviewed were person centred and where people needed assistance with personal care there was very little information for staff which detailed how people needed assistance.

We found that Offington Park did not have adequate internal audit processes in place to enable the home monitor compliance to Care Quality Commission regulations. The home was not following their policy and procedure when handling and administering medication which are described 'as required'.