Archived: Mersey Parks Care Home

Mersey Parks Care Home is a purpose built care home and provides care in four separate buildings on the one site. Each building can accommodate up to 30 people. One of the units provides nursing care and three provide residential care. The home provides nursing and personal care to older people and people who are living with dementia. The home is located in a residential area with good access to public transport. At the time of our inspection there were 103 people living at the home.

The service had 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.

At the last inspection on 29 July 2014, we found the provider was meeting the requirements of the regulations inspected.

During this inspection, we observed the administration of medicines at lunchtime. People said they received their medicines when they needed them. However, staff did not always administer medicines safely because records had not been completed in line with the service’s policies and procedures.

We made a recommendation about the safe administration of medicines and have been provided with evidence to demonstrate this has been addressed.

Medicines were safely and appropriately stored and secured safely when not in use. We checked how staff stored and stock checked controlled drugs. We noted this followed current National Institute for Health and Care Excellence (NICE) guidelines.

We found staffing levels were regularly reviewed to ensure people were safe. There was an appropriate skill mix of staff to ensure the needs of people who used the service were being met.

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff had received safeguarding from abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were being met. We saw the management team had responded promptly when people had experienced health problems.

Comments we received demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at the home.

Care plans were organised and identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People told us they were happy with the activities organised at Mersey Parks Care Home. The activities were arranged for individuals and for groups.

A complaints procedure was available and people we spoke with said they knew how to complain. People and staff spoken with felt the registered manager was accessible, supportive and approachable.

The registered manager had sought feedback from people who lived at the home and staff. They had consulted with people and their relatives for input on how the service could continually improve. The provider had regularly completed a range of audits to maintain people’s safety and welfare.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Is the service safe

On the day of our visit we found the environment clean and fresh.

We saw adequate staff on duty to meet the needs of the people living at the home and were told that a member of the management team was always available either working in the home or on call in case of emergencies.

A safeguarding policy and procedure was in place to advise staff what they should do if they suspect abuse and staff received regular training in safeguarding. We spoke to six staff members who all demonstrated a good understanding of types of abuse and how to protect the welfare of vulnerable people.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. Proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one. There were three DOL's in place at the time of this inspection.

Is the service effective?

People told us that they were happy with their care. We spoke with staff and found that they knew the people living in the home well. A family of one person told us that the home met their needs and much more. The people who lived at the home and the relatives we spoke with told us they were given a choice as to how they lived life at the home. They told us staff always sought their consent before support was provided. People's comments included "staff always ask if I want some privacy when doing personal care for me", "staff are really helpful" and "very nice staff". A relative said "this is a great place here, the staff are lovely. They do anything they can do to help".

Care records showed evidence that people and/or their relatives were involved in regular discussions about their care and that they had received the care and support outlined in their support plan.

We saw training records which identified that staff received training relevant to the needs of the people who lived in the home.

Is the service caring?

We spent time in all areas of the home and saw and heard staff to be kind and patient to the people who lived there. We saw that the people who lived in the home were comfortable in the company of staff and the manager and happy to have a chat with them. One person told us 'I'm happy here and feel safe".

We saw that workers were patient and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. One person told us about the staff, "they treat me well".

Is the service responsive?

People's needs had been assessed before they moved into the home and frequently reassessed whilst they lived there.

Records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded. Care and support had been provided that met their needs and wishes. Other professionals, such as speech and language therapists, continuing care and district nurses were involved in peoples care when necessary. We saw that relevant referrals were made to other professionals as and when required.

People had been supported to maintain relationships with their friends and relatives. The majority of the people we saw appeared happy and content in the home and communicated well with staff.

People who lived in the home told us that they were happy with their care. We looked at care plans and saw that they were person centred and updated to reflect the changing needs of people.

Is the service well led?

The home had a new manager in post who had applied for registration as the registered manager with the CQC.

A relative said, "the manager is very good, if there is any issues she or one of the team will phone me".

Staff told us that the management team supported them to attend training.

Staff had a good understanding of the ethos of the organisation and quality assurance processes were in place. The clinical services manager, home manager and senior staff undertook a range of quality audits to ensure risks to people's health, safety and welfare were identified and managed. There were also other quality checks completed by the clinical services manager and monitored by the provider.

Regular resident meetings were scheduled however we were told there was a very poor response. The people living at the home, staff and relatives were asked for their feedback on the service on an annual basis. People's views and opinions were sought and acted upon by the provider.

'The staff are all great. Marvellous. Look after you so well and I like it here. They respect you - where I was before people used to talk about you.'

'The staff are all very good. We all have our moments and they are no different but they always speak to you properly and treat you with respect.'

'They always treat mum with respect and are very knowledgeable about what she needs. They are patient with her and give her time to respond.'

'They encourage you to do things for yourself and give you independence.'

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. During our visit we spoke with two visiting social workers and a community matron who told us that staff could be relied upon to follow any instructions or guidance given.

The people who accessed the service provided at Mersey Parks Nursing and Residential were cared for by staff that were appropriately recruited, well trained and experienced at supporting them. People were protected from the risk of infection because appropriate guidance had been followed and systems were in place to deal appropriately with any complaints.

During our visit we saw evidence that care plans were detailed and contained enough information for people to be cared for safely and effectively. We also saw that comprehensive risk assessments were part of the care planning process. We reviewed the management of medicines and found that medicines were kept and administered safely and disposed of appropriately when no longer in use.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. During our visit we spent time speaking with two relatives of people who used the service, as well as a visiting healthcare professional. Relatives we spoke with commented on how they felt standards at the home had improved in recent months. One person we spoke with told us that the staff "couldn't be better' and that they had kept the family informed of any changes to their relative's condition.