Compass Care - South Park

Updated 10 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors, a medicines inspector and an Expert by Experience (ExE). An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Compass Care – South Park is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Compass Care – South Park is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The provider also operates a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 20 June 2023 and ended on 04 July 2023. We visited the service on 20 June 2023 and 03 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, commissioners and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who use the service and 4 relatives about their experience of the care provided. The quality of life tool was utilised. This tool focuses on the experience of people receiving care and what it feels like for them to be using the service.

We spoke with 12 staff members including the registered manager, carers, and domestic staff. We spoke with 2 healthcare professionals who worked with the service. A range of records were reviewed including 3 people's care records and multiple medication records.

We looked at 3 staff files in relation to recruitment and supervision. We reviewed records relating to health and safety and the management of the service, including policies and procedures and quality assurance records.

Updated 10 August 2023

About the service

Compass Care – South Park is a residential care home providing accommodation and personal care for up to 10 people. This includes people living with sensory impairments and people living with a learning disability. At the time of our inspection 10 people were using the service.

The provider also operates a domiciliary care agency, which was providing personal care to 1 person at the time of inspection.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance The Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

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’s care records were person centred. They reflected people’s individual needs and risks to enable staff to support them safely.

Staff adapted their communication style to meet people’s needs and actively engaged with them. Information was provided for people in adapted formats where required.

People were always given a choice regarding their care, support, and daily lives. Staff supported people to participate in activities that were important and enjoyable to them.

Staff knew people well and had built positive and trusting relationships with them.

Right Care:

Care records detailed people's preferences regarding how their care should be delivered. This meant people received person centred care, from a staff team who knew people well.

Staff supported people in a kind and caring way that respected their privacy and dignity. People were encouraged to maintain their independence.

The service worked in partnership with healthcare professionals to care for people holistically and meet their health and support needs.

Right Culture:

There was an open and positive culture at the service which placed people at the centre of care delivery and achieved good outcomes for them. People were supported to live inclusive lives and access the community.

Systems and processes were in place to monitor the quality of the service and drive improvements.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 08 October 2019) and there were breaches of regulation. 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 regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. 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 COVID-19 and other infection outbreaks effectively.

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

Recommendations

We have made recommendations regarding systems and processes for reporting safeguarding incidents and recording information relating to recruitment.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.