Archived: Churchview Care Home

Updated 13 November 2019

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 Care Act 2014.

Inspection team

One inspector and an Expert by Experience visited the service. 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

Churchview is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

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, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We reviewed information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and four relatives and friends about their experience of the care provided. We spoke with nine members of staff including the provider, the registered manager, a nurse, four care workers, the cook, and a domestic staff member. We also asked a hairdresser and three visiting health professionals for their feedback.

We reviewed four people's care records and multiple medicine administration records. We looked at three staff files in relation to recruitment and viewed training and staff supervision records. We looked at a selection of records relating to the management and running of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The provider sent further supporting documentation for us to consider. This included; a training matrix, policies and procedures and an action plan to address concerns we found during the inspection.

Updated 13 November 2019

About the service

Churchview Care Home is a residential care home spread over two floors. The service provided personal and nursing care to 23 older people, younger adults, and people living with dementia and sensory impairment. The service can support up to 30 people.

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

Systems and processes including governance systems, failed to identify and assess all risks to the health, safety and/or welfare of people who use the service.

For example, certified safety checks had not been completed following the supplier’s guidance and additional monthly checks required further information to assure continued safe use and operation of bed rails to mitigate known risks.

People received support with their medicines as assessed. However, staff had failed to follow policy guidance to ensure medicines prescribe as creams or patches were safely administered with appropriate associated records implemented and maintained. Monthly audits were completed but daily checks failed to implement corrective actions within reasonable timescales to mitigate known risks.

Staff received induction, training and support to carry out their duties. However, there was no evidence of a formal process in place for ongoing or periodic reviews to record where staff were assessed for their competency. For example, to manage and administer peoples medicine. Checks failed to ensure records of supervisions captured how staff were supported in their role and to meet their aspirations.

People’s needs were assessed as required to maintain compliance with the Mental Capacity Act 2005. Some risk assessments and support plans required implementation and updating. For example, where it was agreed to restrict access outside of the home.

People were supported with their health and wellbeing. Records included evidence of involvement from health professionals. This included input from GP’s, occupational therapists, physiotherapists and psychiatrists.

Staff understood how to keep people safe from abuse. People were supported to remain involved with any religious preferences and staff confirmed supporting any diverse needs and treating people equally was embedded into their roles.

People spoke with enthusiasm about the meal time arrangements and the quality of food and support they received. Where people had any dietary requirements, these were supported, and people were monitored to ensure they achieved positive outcomes.

The provider ensured people were supported to enjoy meaningful activities. These included regular trips out, daily events, shows and where people choose to remain in their rooms, daily support and interaction tor remain free from social isolation.

Staff were caring. They understood how to empathise with people who showed signs of confusion due to their dementia. Staff were patient and treated people with dignity and respect.

The registered manager and the provider were passionate about providing a safe service that was based around the needs of the individual person. They were responsive to the concerns we raised during the inspection. Where appropriate some actions were implemented immediately to maintain people’s safety. Other actions were planned for implementation on an action plan to determine the required improvements.

People and their relatives told us they were able to contribute their feedback to maintain and improve standards of care and support. They told us they were confident if they had any complaints the registered manager would address them appropriately.

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 30 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because where quality and safety concerns were found during the inspection associated governance did not ensure all corrective actions were implemented without unnecessary delay. This placed people at risk of harm.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.