Church View Residential Home

Updated 8 September 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 an Expert by Experience. 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

Church View Residential home 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. Church View Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included, feedback, concerns, investigations, action plans and statutory notifications which the provider is required to send to us by law. We also sought feedback from professionals. 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 five people who used the service, two relatives and two visiting professionals. We spoke with six staff members. These included, one domestic staff, an activities co-ordinator, one carer, a senior carer, the nominated individual and the registered manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at five people’s care records, associated documents, medicines records and medicines related documentation. We also looked at three staff files, training and supervision records, as well as records relating to the operation and management of the service. We undertook a tour of the building, observed medicines administration and their storage, and completed observations in the communal areas.

Updated 8 September 2022

About the service

Church View Residential Home is a residential care home providing personal care to up to 30 people in a single storey adapted building. The service provides support to older people and people living with dementia. At the time of our inspection there were 20 people using the service.

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

There were not always enough staff to ensure peoples’ safety at night. Systems to identify and reduce risk were not robust enough. Risk assessments were not always in place or updated when people’s needs, or risks changed. Medicines were not always managed safely or in line with prescribers’ directions. Infection prevention and control guidance on good practice were not always being followed. People felt safe in the service. Staff were recruited safely and knew how to report and recognise safeguarding concerns.

Staff did not consistently receive training in key areas or regular supervision. The design and adaptation of the home environment needed to be improved, to ensure it met the needs of people living there, we have made a recommendation about this. People spoke positively about the care they received. They felt able to make decisions around their daily routines. People’s dietary and nutritional needs were met, and they told us they enjoyed their mealtimes. The provider worked in partnership with other agencies to support people to maintain their health and wellbeing.

Peoples were being treated with dignity and respect. We have made a recommendation about the location of call bells in people’s room to support them to maintain their independence. People and relatives told us staff were caring.

Staff provided people with person centred care. We have made a recommendation about people and their families being involved in the care planning process Activities were being offered at the service and processes and systems were in place to respond to complaints. 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 did not support this practice. We have made a recommendation around capacity and best interest. People could have visitors without restrictions and were supported to have pets to meet their emotional wellbeing needs.

Systems and processes to oversee and manage the service were not always effective. The views of people, families, staff and professionals about the care provided were not regularly being sought. Staff and residents’ meetings were not regularly occurring. Staff and people spoke highly of the registered manager and found her supportive.

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 19 November 2019). At that inspection we found breaches of regulations relating to staffing levels and oversight of the service. The provider completed an action plan after that inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider improved their admissions process and completed staff surveys. At this inspection we found the provider had improved admissions processes however they had not implemented staff surveys.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 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 Church View Residential home 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 staffing levels and staff training, safe management of medicines, the management of risks, and the operation and oversight of the service at this inspection. We have also made recommendations about the location and use of call bell systems, mental capacity assessments and best interests’ decisions, and around ensuring care plans are robust and people are involved in care planning.

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 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.