The inspection took place on 19 October 2015 and was unannounced.
Victoria Royal Beach is a privately owned care home in Worthing and is registered to provide care for up to 20 people. At the time of our inspection, there were 16 people living at the home and all rooms were single occupancy. Victoria Royal Beach has been converted into a home from three properties that were originally terraced. It is situated within a few minutes of the seafront at Worthing and close to the town centre. The majority of rooms have en-suite facilities and those facing on to Grand Avenue, at first floor level, have a balcony. Communal areas comprise a large sitting room, dining area within a conservatory and a quiet lounge, where people can meet with relatives and friends. The home has accessible gardens to the front and side and there is a five person lift within the property.
The person currently managing the home had not yet registered with the Commission as they had only been in post for three months and were in the process of completing their probation period with the provider. 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’s medicines were not always managed so that they received them safely. Some Medication Administration Record (MAR) charts had not been completed correctly, which meant that some people may not have received their medicines as prescribed. Two medicines had been over-ordered and stocks of these medicines were excessive. A refrigerator to store some medicines was not locked. MAR charts, containing people’s information, were left out on a shelf in a room with the door open and were not kept confidentially. No formal system was in place to audit medicines to ensure this was managed safely.
There were no formal processes or systems in place to audit the quality of care delivered. Risks were not always assessed and monitored overall to ensure people’s safety. No formal meetings were arranged that enabled people or their relatives to feed back their views about the service.
People were protected from abuse and harm. Staff were trained to recognise the signs of potential abuse and knew what action to take. Individual risks to people had been identified and assessed and care plans provided information and guidance to staff on how these should be managed. When accidents or incidents occurred, these had been reported in line with legislation. However, the reports did not identify steps that could be taken to prevent a reoccurrence. Staffing levels were sufficient to meet people’s needs safely and the provider followed safe recruitment practices.
People were looked after by staff who had received training in all essential areas. New staff were required to complete the Care Certificate, a universally recognised qualification. Staff had regular supervision meetings, but no arrangements were in place for formal staff meetings. However, staff communicated information about people’s care needs at daily handover meetings between shifts. Staff had a good understanding of the need to gain people’s consent before delivering care. People’s capacity to make decisions had been assessed in line with the requirements of the Mental Capacity Act 2005 (MCA). People did not have their freedom restricted and no applications had been made to the local authority under the provisions outlined in the Deprivation of Liberty Safeguards (DoLS).
People were supported to have sufficient to eat and drink and to maintain a healthy lifestyle. A variety of meals were on offer and people could choose from several options on the menu. Special diets were catered for and people’s nutrition was assessed and their weight was recorded and monitored. People had access to a range of healthcare professionals as needed.
People were looked after by kind and caring staff who knew them well and they were encouraged to be as independent as possible. People were treated with dignity and respect. When they reached the end of their lives, they were supported to have a comfortable, dignified and pain-free death in line with what they requested.
Care plans provided detailed, comprehensive information to staff about people and all aspects of their care needs. The majority of care plans included details about people’s life histories, but not all plans were completed consistently and had the same level of detail. There was a range of organised activities at the home, but there was no evidence to show that people had been involved in planning these activities. People could go out with relatives and friends, but there was a lack of staff to support people in the community, unless it was for healthcare appointments.
There was a complaints procedure and policy in place, but no formal complaints had been raised or recorded within the year.
People were not formally asked for their views about the service, although the manager did meet with people every day to obtain their feedback. The manager was fairly new in post and was concentrating on building a fully trained and skilled staff team.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of this report.