Archived: Precious Nursing & Residential Home

Precious Nursing & Residential Home is a residential care home providing personal and nursing care to up to 38 people. The service provides support to people living with dementia, mental health support needs, physical disabilities and sensory impairments. At the time of our inspection there were 25 people using the service.

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

The provider had not always made the safeguarding adults team and CQC aware of safeguarding concerns. People did not always have support to keep their belongings secure. Environmental risks were not always managed. People did not always receive their medicines safely and guidance was not always available to staff about when people needed ‘as required’ medicines. People were not always repositioned when they needed to be to promote their skin health. However, the service promoted clean hygiene practices and staff were recruited safely.

Staff had not always completed training they needed to meet people’s needs effectively. People’s health and mobility related needs were not always monitored consistently. Health professionals told us of concerns relating to their advice not being implemented. We received and observed mixed findings about people’s mealtime experiences. People’s bedrooms were not personalised unless they had support from relatives or external professionals. However, people had their needs assessed prior to them using the service.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; despite the provider’s policies in the service supporting this practice.

People could not always access their care plans to enable their involvement and empower them to ensure their needs and preferences could be understood and met. People did not always have enough clothes to wear due to poor laundry processes . However, a relative felt positive about the care a person received and we observed staff respecting people’s privacy.

End of life plans were not always in place for people. Complaints and concerns had not been recorded or acted upon. People’s care plans were not always fully personalised. Improvements were needed so people could engage in activities meaningful to them. Accessible information was needed to enable people to seek support outside of the service. However, care plans did contain information about people’s communication needs.

There was not always effective management oversight of the service. Audits had not always been carried out or used to identify shortfalls in quality and improvements needed. Accurate and complete records were not always kept. The provider had not met all of their regulatory requirements. People were not always spoken about in a positive way. However, staff felt comfortable with approaching the registered manager with concerns.

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

Rating at last inspection

This service was registered with us on 11 January 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. 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.

Enforcement

We have identified breaches in relation to safeguarding, people’s safety, the safety of the premises, staffing, dignity and respect, consent and governance.

Please see the action we have told the provider 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.