Shackleton Medical Centre

Updated 31 December 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and a nurse specialist advisor. An Expert by Experience carried out telephone interviews with relatives following the inspection. 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

Shackleton Medical Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Shackleton Medical Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

At the time of our inspection there was not a registered manager in post. A new manager had been in post for seven month and had submitted an application to register. At the time of the inspection we were assessing this application and the manager was registered following the inspection.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with one person who used the service, five relatives and one friend of a person living at the home. We also spoke with nine staff members which included the manager, clinical lead, a nurse and care workers. We reviewed a range of records which included seven people’s care plans, various medicines records and the recruitment and supervision records for four staff members. After the visit to the service we continued to seek clarification from the provider to validate the evidence we reviewed.

Updated 31 December 2022

About the service

Shackleton Medical Centre is a care home that can provide accommodation and personal or nursing care for up to 26 people with both nursing and general care needs and end of life care. At the time of the inspection there were 22 people living at the care home.

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

The provider had not always developed risk management plans to provide guidance on how identified risks to people could be mitigated. When an incident or accident had occurred, the investigation did not always identify what lessons could be learned to reduce the risk of reoccurrence. The provider had a process for the reporting of safeguarding concerns, but this was not always followed. The provider had not always followed their processes when recruiting staff to work at the home to ensure they were suitable for the role.

The provider had not always ensured the environment was safe and suitable. They had also not always ensured there was sufficient guidance for staff on how to provide care in a person-centred manner. People’s communication support needs were not always identified. There was a range of quality assurance processes in place, but these were not always robust enough to indicate to the provider where improvements or action were required. Staff had not always completed the training identified as mandatory by the provider or competency assessments such as those with moving and handling before they could work with people.

There was a process for the administration and management of medicines which was followed, but we identified further training and action was required. We have made a recommendation in relation to the management of medicines.

Relatives were overall happy about the care their family members received and told us they felt their family member was safe when they received care in the home. We saw that individually care workers supported people in a kind, caring and respectful way. People’s care needs were assessed before moving into the home. People were supported to assess healthcare when required so they remained as healthy as possible.

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.

Staff supported people to maintain relationships with people who were important to them. The provider responded to complaints in a timely manner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. This service has been rated either requires improvement or inadequate for the last five rated inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shackleton Medical Centre on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care, safe care and treatment, safeguarding services users from abuse an improper treatment, staffing, premises and equipment, good governance and fit and proper persons employed at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.