Background to this inspection
Updated
12 April 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place over five days between 10 to 17 January 2017, and it was unannounced. The inspection consisted of two site visits which were carried out by an inspector and two experts by experience on 10 and 12 January 2017. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. We then received telephone calls from relatives in response to our inspection on 11 and 13 January 2017. We completed the inspection on 17 January when we received information from the provider which had been requested as part of the inspection, and had received the final feedback from relatives.
Before the inspection, we reviewed information we held about the service, including the previous inspection report and notifications they had sent us. A notification is information about important events which the provider is required to send to us. We also reviewed information of concern we had received in the last 12 months either from the local authority, members of the public or staff.
During the inspection, we spoke with 20 people who used the service, 11 relatives, 8 staff including care staff and nurses, the safeguarding manager and the general manager, regional manager and head housekeeper.
We looked at the care records for 14 people who used the service. We reviewed the provider’s staff recruitment, supervision and training processes. We checked how medicines and complaints were being managed. We looked at information on how the quality of the service was assessed and monitored, and we observed how care was being provided in communal areas of the home.
Updated
12 April 2017
This unannounced inspection took place when we visited the service on 10 and 12 January 2017. It was completed on 17 January 2017 when we had received all requested information and feedback.
The service provides care and nursing support to people with a variety of needs including those associated with living with dementia. The home is divided into two units. The 'Assisted Living' unit located on the ground and first floor of the home can accommodate up to 69 people who are elderly and frail. The 'Reminiscence' unit is located on the second floor of the home and can accommodate up to 31 people with higher care needs and dementia. On the day of our inspection, there were 93 people being supported by the service. The home is a purpose built care home with private grounds within a gated environment. The home is decorated to an extremely high standard which gives the home the feel of a five star hotel. There is a concierge service available, Wifi and a Bistro service. People within the home were provided with small apartments rather than rooms. These consisted of a living room/ kitchenette, walking shower room and two bedrooms. People could choose to share an apartment with another person using the service or have them for sole use.
There was a registered manager in post. 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.
There was not always enough staff to support people within the home.
The provider did not promote an inclusive culture in the home and decisions were sometimes made without proper consultation with people or their relatives.
People’s medicines were managed safely. Potential risks to people’s health, safety and welfare had been reduced because there were risk assessments in place that gave guidance to staff on how to support people safely. There were systems in place to safeguard people from avoidable harm and staff had been trained in safeguarding procedures. The provider had effective recruitment processes in place.
Staff had regular supervision and they had been trained to meet people’s individual needs. They understood their roles and responsibilities to seek people’s consent prior to care and support being provided. The requirements of the Mental Capacity Act 2005 (MCA) and the related Deprivation of Liberty Safeguards (DoLS) were being met.
People were supported by staff who were kind, caring, friendly and respectful. They were supported to make choices about how they lived their lives and how they wanted to be supported. People had enough to eat and drink to maintain their health and wellbeing. They were supported to access other health services when required.
People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices. Where possible, people and their relatives had been involved in reviewing people’s care plans. People had been provided with a variety of activities facilitated by the activities coordinator.
The provider had a formal process for handling complaints and concerns. They encouraged feedback from people who used the service, their relatives, external professionals and staff, and they acted on the comments received to continually improve the quality of the service.
The provider’s quality monitoring processes had been used to drive continuous improvements but was not always effective in monitoring people’s expectations of the service. The manager provided stable leadership and effective support to staff, Staff were motivated to do their best to provide good care to people who used the service and to work in collaboration with people’s relatives.
We found the provider was in breach of a regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.