Background to this inspection
Updated
16 November 2022
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 two inspectors and an Expert by Experience. 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
Camelot Nursing and Residential Care Home 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. Camelot Nursing and Residential Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 the Care Quality Commission 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 24 October 2022 and ended on 28 October 2022. We visited the location’s service on 24 October 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection including the action plan submitted. We sought feedback from 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
During the inspection we observed support people received throughout the day. We spoke with four people who used the service about their experience of the care provided and 12 relatives of people who use the service. We spoke with one health care professional who regularly visited the service. We spoke with seven members of staff including the registered manager, the administration, registered nurses, care staff and kitchen staff.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
Updated
16 November 2022
About the service
Camelot Nursing and Residential Care Home is a residential care home providing personal and nursing care to up to 36 people. The service provides support to older people with age related frailties and health conditions, this includes Parkinson’s disease and epilepsy. At the time of our inspection there were 33 people using the service.
People’s experience of using this service and what we found
Quality assurance processes were mostly effective to provide managerial oversight of all systems in the service. Audits of care records carried out by the management team had not always identified some inconsistencies in people’s care records. The registered manager rectified the discrepancies immediately and shared plans to further monitor records. Other quality assurance processes were effective in identifying areas for improvement which fed into a quality improvement plan. The management team worked in partnership with professionals to continually learn and develop the service.
People received their medicines by registered nurses who were trained and competent to administer them safely. People who required time specific medicines received them at the right time each day. People and their relatives were aware of any changes to their medicines. One relative told us, “I'm updated with changes like medication or if [person] has a urine infection, that sort of thing.” People were protected from the risk of infection such as, the COVID-19 pandemic. Staff followed policies to keep people safe, wore appropriate personal protective equipment (PPE) and practices good hand hygiene.
People’s health risks were assessed and managed safely. Where people had associated health risks, such as Parkinson’s and epilepsy, risk assessments and care plans guided staff on how to safely support them. People were supported to go out with friends and family, risk assessments enabled this to be done safely. People told us they felt safe and felt comfortable to speak with staff or management if they had any worries or concerns. One person told us, “I feel safe, if I press the bell, they (staff) will come. Most of the time I don’t need to as they pop in a lot.” Staff received safeguarding training and understood their duty on how to prevent and report potential concerns of abuse.
People were supported by enough staff who knew them well. Staff were recruited safely and received training relevant to their role. People were complimentary of the care staff. Comments included, “I couldn’t be more well looked after. They are really good and work so hard. Lots of staff have a good sense of humour which I like as I think I have too. I have six favourites but I'm not naming names, they are all great.” And, “The staff are extremely good.”
People said they were involved in planning their care and were given opportunities to give feedback on the service. One person told us, “I am very happy with my care, we plan it together and I can make changes when I want.” When speaking about their involvement with the service, one person said, “I have filled in questionnaires I think two already. I have made suggestions, just things like how I wanted my room set up, it was all done for me as I wanted.”
People, their relatives and staff told us they felt comfortable to make suggestions or complain if needed, they were confident the management team would deal with any problems. Most relatives told us staff and management kept them up to date with changes to their loved ones. One relative said, “I know the manager seems to be doing a good job, there is an open door policy, my relative likes them.”
Staff and the management team worked closely with health and social care professionals to improve people’s care, safety and well-being. One visiting health care professional told us, “[Registered manager] is turning things around, staff when they were out of ear shot said how pleased they were that [registered manager] is their manager.”
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.
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 16 August 2021) 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 safe care and treatment.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced focussed inspection of this service on 3 and 4 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to check whether the Warning Notice we previously served in relation to Regulations 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, good governance had been met. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Camelot Nursing and Residential Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.