The Poplars

The Poplars is a residential care home providing personal care to 27 people aged 65 and over at the time of the inspection. The service can support up to 33 people in one adapted building and supports people who may be living with dementia and physical impairments.

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

People were not always safe as the physical environment was not always suited or adapted to meet their needs.

The provider had assessed the risks associated with people’s care and support. Staff members were knowledgeable about these risks. However, some staff practice was not in accordance with safe care.

Although there were enough staff to meet people's needs, people found their interactions to be task driven and their opinions not sought in a meaningful way.

The provider had quality monitoring processes in place. However, these were not always effective in identifying improvements needed to ensure the safe provision of care.

People received safe support with their medicines from staff members who had been trained and assessed as competent. Staff members followed effective infection prevention and control procedures when supporting people. However, not all aspects of the physical environment supported effective infection prevention and control practices.

People were protected from the risks of ill-treatment and abuse as staff had been trained to recognise potential signs of abuse and understood what to do if they suspected harm or abuse.

People were supported to have maximum choice and control of their lives and the provider supported them in the least restrictive way possible and in their best interests; the application of the policies and systems supported good practice.

The provider, and management team, had good links with the local communities within which people lived.

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 3 September 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 remained requires improvement, based on the findings of 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 the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

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

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach of the regulations in relation to keeping people safe and overall management of the home.

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

Follow up

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

The Poplars is a residential care home providing personal care to 26 people aged 65 and over at the time of the inspection. The service can support up to 33 people in one adapted building and supports people who may be living with dementia and physical impairments.

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

Medication management required strengthening. We have made a recommendation about the management of some medicines. The provider did not have a systematic approach to staffing levels based on people’s needs. The provider was aware of their duty of candour and worked in partnership with other professionals.

People were supported to express their views; however, we have made a recommendation about the provider ensuring this is documented.

People and relatives told us staff were caring and people were supported by kind and respectful staff. People had their privacy maintained and their dignity promoted.

Risks to people were assessed and people told us they felt safe. Staff were safety recruited and there were enough staff to meet people’s needs. People were protected from the risk of cross infection as staff wore personal protective equipment and lessoned were learned when things had gone wrong.

People received effective care from the service. Pre-assessments were completed, so the registered manager knew they could meet the needs of people before they moved in. People told us they liked the food and had enough to eat and drink. Staff worked with health professionals to ensure people received timely 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 received personalised care to meet their needs and were supported to take part in activities within the home. The service was following the Accessible Information Standard and had complaints policy in place. People’s end of life wishes were considered and documented in care plans.

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 21 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

At the time of the inspection there were two registered managers in post. The provider had two registered managers in post as they were job sharing. 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.

People told us they felt safe living at the home. People were supported by adequate numbers of staff who had been recruited safely. People were supported by staff who knew their risks and how to work in ways to reduce risks. People were supported by staff who knew how to recognise and report concerns about potential abuse. People received their medicines as prescribed from staff who had received appropriate training.

People were supported by staff who were appropriately trained and supported to perform their role. People were asked for their consent before care and support activities were carried out, and the principles of the Mental Capacity Act 2005 were being followed. People were offered choices of food and drink and were supported to maintain their health.

People were supported by staff who treated them with kindness and respect. People were supported to make decisions about their care and support. People’s privacy, dignity and independence was promoted and maintained.

People were supported by staff who understood their care and support needs and preferences. People’s care records were regularly reviewed to reflect changing needs and people and their relatives were involved in review of their care. People had opportunities to engage in activities and were supported to follow personal interests and hobbies. People knew how to raise a concern or complaint and the provider had a complaints process.

Systems to monitor the quality and consistency of the service were not always effective at identifying concerns or improvements required to the recording practices. People and their relatives were complimentary about the home and how it was managed. People, relatives and staff were given opportunities to provide feedback and the information was being used to improve the service.

Below is a summary of what we found during our inspection. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

We also wanted to know if the provider had made any improvements to records since our last inspection.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service felt safe. A person told us: "Yes I do feel safe here. I feel safe and well cared for". Another person said: "I can walk away from here knowing that x is safe. That is of great comfort to me". People who used the service had individual risk assessments in place to help keep them safe. Staff were trained in how to keep people safe and were aware of their responsibilities in raising concerns about poor practice and/or abuse.

Is the service caring?

People we spoke with felt well cared for and we observed staff to be caring and attentive to the needs of people. One person said: "Care is very high on the agenda here". Another person said: "X would not be here now if it wasn't for the excellent care they have received here".

Is the service responsive?

We saw staff responded to the diverse needs of people. Three people explained to us how the staff had responded to the specific needs of their relatives. They were all pleased with the improvements their relatives had made as a result of this.

Is the service effective?

Care plans were regularly reviewed for their effectiveness. Visiting health care professionals worked alongside staff in the home to ensure that people received the right care and support.

Is the service well led?

The providers and care managers worked with each other to provide good management of the service. This helped to ensure that people received good quality care and support.

The environment was homely and welcoming with wonderful views. However we saw that the gardens were not secure. The provider may wish to note that this may provide a risk for people who had dementia.

People who used the service were cared for by a skilled and competent staff team who were trained to meet their needs. Staff felt supported by the owner who often provided training for them.

The provider was in the process of changing from paper records to a computerised system. As a result of this some of the records we looked at were inconsistent and some information was missing. Also some of the records relating to the administration of medication were incomplete. The provider will need to review the way that records are maintained in order to improve the effectiveness of these.

We observed most people using the lounge areas and spoke to three people in their own bedrooms.

We looked at six people's care records and found that five were well documented and had regular reviews in place. At the time of the visit the manager and senior care told us that one person's well being had deteriorated. The care plan for this person did not reflect the changing needs of the person. The senior carer told us that they would look at this as a matter of urgency.

The people we spoke with told us that the care they received was good and they had no complaints One person said 'the staff are so lovely and kind they look after us well, I ask for an early breakfast and I get it''.

We saw that staff were present in all areas of the home and people who chose to stay in their rooms told us they saw the staff regularly and would come if they needed them.

We spoke with six visitors who all expressed their satisfaction with the care. One visitor said ' we notice a marked improvement in x ' since she has been here.

Staff spoken with were able to explain their understanding about safeguarding vulnerable adults. They told us that if they had a concern they would tell the senior or the manager. People told us they would speak with the senior or their relative if they had any concerns about the care they received.