The service accessed COVID-19 testing in accordance with the relevant guidance. When positive test results were received, the service reported them and requested specialist support to help manage the outbreak.
Further information is in the detailed findings below.
Church View 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. Church View accommodates up to 45 people in purpose-built premises.
The home manager had been registered by CQC in August 2017. 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. People we spoke with considered that the manager was approachable and was effective in her role.
We found there were enough staff to meet people’s support needs and new staff were recruited safely. Training was provided to ensure staff had the knowledge and skills to work safely and effectively. Staff were supported in their role through individual supervisions.
Health and safety checks were completed on a regular basis and the premises and equipment were clean and well maintained. Risks to people’s health and safety had been assessed and action to taken to mitigate the risks. Accidents and incidents were recorded and analysed. People’s medicines were managed safely.
People told us they felt safe in the home and that they had no concerns regarding their care. They told us the staff were kind and caring and protected their dignity and privacy.
Applications to deprive people of their liberty had been made appropriately. Records showed that consent was sought in line with the principles of the Mental Capacity Act 2005.
People received the supported they needed to eat and drink and their dietary needs and preferences were catered for.
People’s needs were assessed and care was provided support in line with their wishes. People's independence was promoted and they were involved in the planning of their care. People could choose how they spent their time.
People told us they enjoyed the social activities and trips out that were provided in the afternoons.
Complaints were handled and responded to appropriately.
The registered manager and senior managers completed regular quality monitoring audits which identified any areas needing improvement. People who lived at the home and their relatives were able to give their views through surveys and meetings.
At our last inspection on 18 and 22 August 2016 we found that systems and processes for assessing, monitoring and improving the quality and safety of the service people received were ineffective. This was a continuing breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities). We also identified a breach in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities). This was because medicines were not being managed safely. At this inspection we found improvements had been made and the provider was now meeting legal requirements. However the improvements made in relation to the quality assurance systems and processes need to become embedded into day to day practice and sustained.
This is the second consecutive time the service has been rated Requires Improvement.
Church View 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. Church View accommodates up to 60 people in one adapted building where accommodation is arranged over three floors. The upper floors are accessed by way of stairs or a passenger lift.
The serviced had two registered managers one of whom had left the employment of the provider. The new registered manager had become registered in August 2017 and was in charge of the day to day management of the service. 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.
Since the last inspection the provider had implemented systems and processes for assessing the quality of the service. These had been effective in highlighting areas that the service needed to improve in but need to become embedded into day to day practice and sustained.
Improvements had been made in relation to the management of medicines which were stored appropriately and administered to people when they needed them. Medication administration records had been completed and were up to date and accurate.
Since the last inspection staff had completed the training the provider considered mandatory. Staff were also supported in their roles and had the opportunity to discuss their personal development and obtain nationally recognised qualifications in care. The registered manager told us further training would be provided for staff in relation to meeting people’s specific needs.
Most people were satisfied with the opportunities for them to participate in activities they found stimulating and meaningful such as outings and group activities, however some felt they did not have much to do. The registered manager explained a wider range of activities would be available once they had recruited another activities organiser.
Some information was available to people in a format that was accessible to them such as pictures of food choices. However further development was needed to ensure other information such as the activity timetable was also available in an accessible format.
Most people felt most staff were kind and caring however we found some staff did not always refer to people and their care needs in a respectful and dignified manner. The registered manager took immediate action to address this however it is an area of practice that needs to become embedded into day to day practice.
People’s needs were assessed and care was provided support in line with their wishes. People's independence was promoted and they were involved in the planning of their care. People could choose how they spent their time and were offered choices in relation to their care and treatment.
People were supported to eat and drink sufficient amounts and their dietary needs and preferences were catered for. People’s health was monitored and staff responded when their health needs changed. People were cared for in a clean, hygienic and well maintained environment and staff had access to personal protective equipment.
People were supported by staff who worked within the principles of the Mental Capacity Act 2005 and met the requirements of the Deprivation of Liberty Safeguards. People's privacy was protected and information was stored securely. People were listened to and complaints were handled and responded to appropriately.
People were supported by sufficient numbers of appropriately recruited and suitable staff. People were safeguarded from the risk of abuse because staff were trained in how to recognise abuse and knew how to report it. Where concerns had been identified the local authority had been informed in line with local safeguarding protocols.
Health and safety checks were completed on a regular basis and the premises and equipment were well maintained. Risks to people’s health and safety had been assessed and action to taken to mitigate the risks. Accidents and incidents were recorded and analysed.
Management and staff worked in collaboration with other organisations to improve the service people received and achieve positive outcomes for them. Lines of delegation and roles and responsibilities were clear.
Church View is registered to provide accommodation and care with nursing for up to 50 people. At the time of this inspection there were 44 people living at the home.
Accommodation is provided over three floors. Bedrooms are located on each floor and are all single rooms with a washbasin provided. Bathrooms and toilets are available throughout the home. A very large communal room with a conservatory is located on the ground floor. This provides areas for dining, sitting and watching TV. The conservatory opens off this room which provides additional space. A small room on the ground floor provides a more private lounge for people to use. Car parking is available within the grounds and there is a small enclosed garden at the front of the home.
Church View is owned and operated by a partnership, Mark Jonathan Gilbert and Luke William Gilbert.
The home had a registered manager. 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. At the time of our inspection the registered manager was on planned leave for a period of approximately 12 months. An interim manager had been appointed by the providers.
At our last comprehensive inspection of the home in March 2016 we found a number of breaches of regulations. As a result we served a warning notice on the home for failing to provide safe care and treatment. Requirements were also given to the home for failing to ensure people were treated with dignity and respect, obtain consent for treatment from people, safeguard people from abuse, support staff and provide good governance for the service. We found that improvements had been made in all of these areas but further improvements were needed to meet all parts of these regulations. However, in response to the improvements that had been made we took the home out of special measures.
At our last inspection we found that medicines were not always properly and safely managed. At this inspection we saw that improvements had been made, but further improvements were needed. We found that storage issues in the medication room made it difficult to locate medication easily. We found that eye drops were stored incorrectly and not dated on opening. Medication recording was at times confusing. These issues had been partly corrected by the second day of our inspection. A new system for medication administration had been introduced within the home which meant people received their medication in a more timely manner.
At our last inspection we found that there were insufficient staff to meet people’s needs effectively. At this inspection we found that improvements had been made to staffing arrangements. However we also found that the way in which staff were deployed needed to be reviewed. We found that people were now receiving the care they needed in a timely manner, however staff and people living at the home felt that there were insufficient staff available and that staff felt stressed as a result of their workload.
At our last inspection we found that adequate systems were not in place to recognise incidences of harm and abuse. At this inspection we found that improvements had been made to systems for recognising and reporting abuse or potential abuse. We found that staff knew how to recognise and report potential abuse and had done so. We also saw that the management team took action to deal with any safeguarding allegations that arose.
At our last inspection we found that parts of the premises and equipment were not safe for people to use. At this inspection we found that the premises and equipment were safe for people living at the home. A new call bell system and door closures had been fitted and regularly tested to ensure they worked safely.
At our last inspection we observed that mealtimes were chaotic, meals appeared unappetising and people waited a long time to be served. At this inspection we found that some improvements had been made but further improvements were needed to people’s lunchtime experience. New meals had been introduced and people said they always received a choice of meal and plenty to eat and drink. However mealtimes remained chaotic and did not appear to be an enjoyable experience for people living at the home.
At our last inspection we found that people did not always received safe care and treatment. This was because equipment they needed to maintain their health was not always used correctly and care plan information regarding the support they needed to stay safe and healthy had not always been followed. At this inspection we found that improvements had been made. People had the equipment that they needed and regular checks had been undertaken to ensure it worked correctly. Care plans contained clear guidance to support people with their health and we saw that this was followed.
At our last inspection we found that the provider did not meet the requirements of the Mental Capacity Act 2005 (MCA). During this inspection we found that this had improved and people were supported to make decisions and were not deprived of their liberty without lawful processes being followed.
At our last inspection we found that people were not always treated with dignity and respect and that their privacy was not always respected. This was because some people’s personal space was used for storage and confidential records were not secured. At this inspection improvements had been made. Dedicated storage areas were used so that people only had their own belongings in their room. Confidential information was securely locked away and people told us that staff listened to them.
At our last inspection we found that risks to the health and safety of service users had not always been assessed and action had not been taken to mitigate them. This was because we had found significant gaps in the information recorded in care records. At this inspection we found that this had improved. People’s needs had been assessed and care plans contained up to date guidance for staff to follow to meet the person’s health and care needs.
At our last inspection we found that systems and processes were ineffective at assessing, monitoring and improving the quality and safety of the service people received and records were not maintained securely. At this inspection we found improvements had been made had been made to the overall management of the home. We also found that systems for monitoring and improving the quality of the service had improved but that further improvement was needed.
People liked and trusted the management team and staff found them supportive. A number of quality assurance systems and audits had been introduced to the home. Any areas identified as needing improvement had been acted upon. However the systems were not yet fully effective at identifying some of the areas for further improvement we identified during this inspection. This included medication management, staff deployment and record keeping.
The large lounge / dining room / conservatory was at times very noisy and therefore appeared un-relaxed with a number of people having to raise their voices to be heard.
Staff knew people well and we saw a number of warm interactions between staff and people living at the home. People told us that they liked and trusted the staff team.
People knew how to raise a complaint and felt confident to do so. Complaints had been listened to and action taken to investigate and deal with the concern.
Robust recruitment procedures were followed to check staff were suitable to work with people who may be vulnerable.
Staff received the training they need to carry out their role effectively and a system was in place to provide supervision for all staff. Staff felt supported by the management team.
Church View is registered to provide accommodation and care with nursing for up to 50 people. At the time of this inspection there were 44 people living at the home.
Accommodation is provided over three floors. Bedrooms are located on each floor and are all single rooms with a washbasin provided. Bathrooms and toilet are available throughout the home. A very large communal room with a conservatory is located on the ground floor. This provides areas for dining, sitting and watching TV, the conservatory opens of this room which provides additional space. A small room was being prepared on the ground floor to provide a more private lounge for people to use. Car parking is available within the grounds and there is a small enclosed garden space to the front of the home.
Church View is owned and operated by a partnership, Mark Jonathan Gilbert and Luke William Gilbert. They have owned the home since May 2015 prior to which it was operating under different ownership.
The home had a registered manager. 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.
At this inspection we found a number of breaches related to treating people with dignity and respect, safe care and treatment of people, safeguarding people, supporting staff and governance of the service. You can see what action we told the provider to take at the back of the full version of this report.
Parts of the premises were unsafe and placed people at serious risk of harm in the event a fire occurred within the home. Equipment did not always work correctly leaving people with no mean to summon help if they needed it. Staff did not recognise and therefore report incidents which placed people at risk of harm.
Staff had not received the support and supervision they needed to carry out their role effectively. There were insufficient staff available to meet people’s needs in a timely manner. This meant people did not always receive their personal care or medication on time or when they needed it.
Some people told us they enjoyed the meals provided, however we found that people did not receive a nutritious diet and the support they received at mealtimes was at times unsafe and undignified.
People’s privacy and dignity was not always respected. They were not always given their mail, their bedrooms and bathrooms were used as storage areas and their confidential records were left unsecured.
The provider did not meet the requirements of the Mental Capacity Act 2005 (MCA). They had not applied for and received Deprivation of Liberty Safeguards (DoLS) for people who needed them. This meant peoples legal rights were not being protected.
Care plans did not provide up to date information to inform staff about people’s support needs. This placed people at risk of receiving unsafe care.
Quality assurance systems were in place but did not operate effectively enough to ensure people received a safe, effective caring, responsive and well led service.
The building had been refurbished and decorated and was waiting a number of finishing touches to make it easier to navigate.
Robust recruitment processes had been followed.
Staff were kind and patient when supporting people. People living at the home and their relatives said they liked the staff team.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:
Ensure that providers found to be providing inadequate care significantly improve.
Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the
system to ensure improvements are made.
Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.
The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location from the providers registration.
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