Promenade Care Home

Updated 1 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 1 inspector.

Service and service type

Promenade 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. Promenade Care Home is a care home without 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

The first day of the inspection was unannounced. We gave a short period of notice ahead of the second day of the inspection.

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. 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 6 people who lived at the home and 2 relatives to understand their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 9 members of staff including the provider, registered manager, deputy manager, chef and care assistants. We reviewed a range of records. This included 7 care plans and associated documentation. We looked at 2 staff files in relation to recruitment and multiple medication records. We reviewed multiple records relating to the management of the service, training data and a variety of policies and procedures.

Updated 1 August 2023

About the service

Promenade Care Home is a residential care home providing personal care to 46 people at the time of the inspection. The home can accommodate up to 49 people and supports older people and people living with Dementia. Promenade Care Home is situated in Southport town centre. Accommodation is provided across 3 floors and people had access to a large lounge, dining area and rear garden.

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

People were at an increased risk of harm as records did not always demonstrate risks to their health, safety and welfare were routinely assessed. Risk assessments were either not completed or not detailed enough to guide staff on how to safely support people. Accident and incident processes were not always effective. Some incident records were poorly completed, and themes and trends were not analysed reliably.

The registered manager did not have oversight of all safeguarding incidents and therefore, appropriate investigation and referral to the safeguarding authority had not always taken place.

People received their medicines as prescribed. However, medicines administration records (MAR) were not always completed in line with best practice guidance, and we found missing signatures on multiple records.

Records relating to food and drink intake were not always reflective of people's needs. This increased the risk of people not being supported effectively in this area.

Monitoring systems had failed to identify all shortfalls found during the inspection process with risk management, accident and incident processes and safeguarding. This meant opportunities to drive improvements to quality and safety were missed.

The provider and manager were receptive to the concerns found during the inspection and took immediate and robust action to reduce the risk of harm to people living at the home. We were assured that enough action had been taken reduce the likelihood of harm before the inspection process concluded.

People told us they felt safe living at the home. Relatives also felt their loved ones were kept safe. The home was clean and hygienic throughout. People and their relatives spoke positively about the cleanliness of the environment.

Our observations found that staff were deployed in sufficient numbers to meet people’s needs. Staff were recruited safely and had the necessary pre-employment checks completed before they started work.

Staff received an induction and completed mandatory training to enable them to carry out their job roles effectively. It was clear from our conversations with staff that they were skilled and knew people well.

There were effective systems in place for staff to escalate any concerns they had about people's health. People and their relatives told us staff were attentive and could pick up very quickly on changes in relation to their health.

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.

Systems were in place to gather feedback from people, relatives and staff and the registered manager understood the importance of using this feedback to improve the home. The registered manager was approachable, consistent, and visible. As a result, staff felt respected, valued and supported.

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 good (published 5 December 2017).

Why we inspected

We received concerns in relation to the management of a person's skin condition. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only.

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.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Eell-led sections of this full report.

The registered manager and the provider were responsive to the concerns we shared and took immediate action to reduce the risk to people living at the home.

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.