13 December 2022
During an inspection looking at part of the service
The Polegate Care Home is a residential care home providing nursing and personal care for up to 44 people. At the time of the inspection there were 25 people living in the service. People were living with a range of nursing and support needs.
People’s experience of using this service and what we found
There were a number of staff vacancies throughout the home. This meant agency staff were being used to ensure staffing levels were maintained. New staff working at the home had not been able to read people’s care plans. There was an over reliance on verbal information sharing and new staff were not always being supported by an experienced member of staff.
Care plans and risk assessments were in place. Care plans were reviewed monthly or more frequently if changes occurred. However, daily records had not been maintained appropriately. Elements of people’s personal care, including mouthcare, repositioning and regular checks were not consistently documented. Staff were not aware which daily charts should be completed for people.
There had not been a registered manager at the service since July 2022. A ‘turnaround’ manager had been put into post by the provider to manage the home until a new manager was recruited. A new manager was due to start in January 2023.
Visitors to the home gave mixed feedback and everyone was aware that there had been a number of staff changes. People told us they wanted more consistency. The provider and manager were working hard to recruit new staff including recruitment from abroad.
Safe recruitment procedures were in place. All appropriate checks were completed before new staff began working at the home. Staff received a three-day induction which included a period of shadowing experienced staff.
There were safe medicine practices and people told us they received their medicines at the right time. Staff administering medicines received training and had their competencies assessed. Staff demonstrated a good understanding of protecting people from abuse. Safeguarding procedures were discussed with staff during group supervisions and any learning taken forward.
Infection control procedures were being followed and the home was clean and tidy. Staff and management were aware of any actions to follow in the event of any outbreaks of COVID19.
People were able to provide feedback about the way they received their care. Resident and relatives’ meetings had been scheduled and staff received group supervisions. Staff told us meetings were a helpful way of communicating any changes. All feedback was being used to implement positive changes to improve the home.
Quality assurance checks and had been completed. This included a programme of auditing which incorporated all aspects of care delivery and services.
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 25 January 2020).
Why we inspected
The inspection was prompted in part due to concerns received in relation to staffing, person centred care and documentation. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement and Recommendations
We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to good governance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve. 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.