Swan Hill House Residential Home

Updated 5 April 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 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

Swan Hill House Residential 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. Swan Hill House Residential 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

This inspection was unannounced.

Inspection activity started on 28 February 2023 and ended on 6 March 2023. We visited the service on 28 February 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 and professionals who work with the service 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 11 people who lived at the home and 2 visitors. We spoke with 7 members of staff which included the registered manager, deputy manager, administrator, cook, head of care, senior care and care staff. The registered manager is also the registered provider. We looked at 3 care plans and multiple medication administration records. We looked at 2 staff recruitment files and training records. We looked at records relating to health and safety and the management of the home.

Updated 5 April 2023

About the service

Swan Hill House Residential Home is a residential care home providing personal care to a maximum of 28 people. The service provides support to older people. At the time of our inspection there were 25 people using the service. Accommodation is provided in one adapted building over 4 floors and 4 bedrooms are for shared occupancy.

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

People were not fully protected from risks associated with the safe management and administration of their medicines. However, the provider acted immediately following the inspection to address the issues raised. People shared mixed views about staffing levels, however we found no evidence that people were at risk of harm. People told us they felt safe living at the home and with the staff who supported them. Staff had been trained to recognise and report any signs of abuse. The provider’s systems for the recruitment of staff helped to protect people from harm. Risks to people were assessed and there were plans in place to mitigate risks in relation to people’s health and well-being. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the provider's policies and procedures supported this practice. People’s protected characteristics were assessed and understood and respected by staff. The provider followed current government guidance in relation to infection control and prevention and management of risks relating to COVID-19.

The provider’s quality assurance systems were not always effective in identifying or improving the quality and safety of the service provided. Audits and checks had not identified the shortfalls found at this inspection. Systems to monitor the competency of staff had not been effective in identifying or addressing areas for improvement. Staff told us they did not receive regular supervisions where they could discuss their role and performance. People were provided with opportunities to express their views about the service provided on a daily basis and through regular surveys. People and staff told us they found the registered manager and deputy manager approachable. The registered manager understood their legal responsibilities and of their responsibility to be open and honest when things go wrong. The provider worked in partnership with health and social care professionals to achieve good outcomes for people.

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 27 February 2019).

Why we inspected

We received concerns in relation to the management of the home, staff recruitment, staffing levels, environmental risks and infection, prevention and control procedures. As a result, we undertook a focused inspection to review the key questions of safe 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.

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

Enforcement

We have found breaches in relation to the safe management and administration of people's medicines and good governance at this inspection.

Please see the safe and well-led sections of this full report. The provider took immediate action during and following the inspection to address some of the issues raised.

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