28 February 2023
During an inspection looking at part of 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.