Background to this inspection
Updated
7 December 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
This inspection was carried out by one inspector.
Service and service type
Squeaks House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 carried out over two days; 28 October 2019 was unannounced, and 29 October 2019 was announced, so we could give feedback with the provider present.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications which tells us about specific incidents that have occurred in the service. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with eight people who used the service and four relatives about their experience of the care provided. We spoke with one of the provider’s partners [referred to as provider in this report] and eight members of staff including the registered manager, deputy manager, senior care workers, care workers, domestic and catering staff. We observed the care and support and interactions between people who used the service and staff.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at a staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training records, reports from fire and health and safety professionals, survey feedback and thank you cards.
After the inspection
We continued to seek clarification from the provider to validate evidence found. This included records relating to medication audits, behaviour monitoring sheets, quality assurance analysis.
Updated
7 December 2019
About the service
Squeaks House Residential Care Home is an adapted building providing personal care for up to 29 older people, including people living with dementia. At the time of our inspection there were 17 people living in the service.
People’s experience of using this service and what we found
People and their relatives told us they were happy with the quality of care being provided.
We found improvements were needed where risks associated with people’s environment were not always being identified and acted on. Action was taken by the provider to address this during the inspection.
People were being supported to take their medicines as prescribed. Where people are prescribed pain relief, on an as and when needed basis, there was no assessment tool used to support staff in identifying pain where a person’s ability to report or verbalise pain is compromised. We have made a recommendation that the service improve in this area.
Recruitment procedures were safe, and people were supported in a clean and hygienic environment. People told us they felt safe living in the service and there were enough numbers of staff to support their needs. Staff knew what action to take if they had concerns over a person’s safety or welfare.
People were cared for by staff who were trained to meet their needs. There was a programme of ongoing redecoration and refurbishment, influenced by feedback from people, their relatives and staff. People’s needs, including in relation to their health and nutrition were assessed and planned for. 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 and their relatives praised the caring, friendly staff and said they would not hesitate to recommend the service to others. One relative told us, “I do recommend to everyone I see.” Staff knew people well and understood their preferred routines, likes and dislikes and what was important to them. They supported people to maintain links with those that mattered to them, and ensured their visitors felt comfortable visiting.
Care plans showed people were being consulted over their care. Staff encouraged people to join in and try new activities to promote their wellbeing. People knew who to talk to if they had any concerns or complaints and felt confident that any would be dealt with.
People were supported by management and staff who enjoyed their work and were highly motivated. The governance systems supported the registered manager and provider to assess the service provided and identify and address shortfalls.
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 28 April 2018).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.