Archived: Angel Court

Updated 27 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of two adult social care inspectors and an adult social care assistant inspector.

Service and service type:

Angel Court is a care home. People in care homes receive accommodation and nursing or

personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of the inspection the home had a new manager in post but they were not yet registered with the Care Quality Commission.

Notice of inspection:

The inspection was unannounced. Inspection site visit activity started on 7 February 2019 and ended on 12 February 2019.

What we did:

Prior to the inspection we had received information about the service since it’s registration on 29 May 2018. This including reviewing any notifications we had received from the service and information we had received from external agencies including the local authority.

This inspection included speaking to one person, two visiting relatives, the manager, a nurse, senior care worker, two care workers, two ancillary workers and the activity organiser. We reviewed three people's care records, six staff personnel files, audits and other records about the management of the service. We spent time observing interactions between staff and people within the communal areas of the home.

After the inspection we requested further information from the manager and registered provider. This was received and the information was used as part of our inspection.

Updated 27 June 2019

About the service:

•Angel Court is a care home providing nursing and residential care. The home is registered to support a maximum of 60 people. At the time of the inspection there were 10 people living at the home. On the first day of the inspection people were living on both Michael unit and Gabriel unit but plans were in place to move people living on Michael unit to Gabriel unit. On the second day of the inspection, all 10 people were living on Gabriel unit.

People’s experience of using this service:

•People were not always safe. We found improvements were needed to the recruitment of staff to ensure procedures were robust and consistently applied.

•Some internal safety checks were had not been completed on a regular basis.

•Not all staff training was up to date. Where staff were responsible for the administration of people’s medicines, training and competency assessments were not completed in a timely manner. Not all staff had received fire training or attended a fire drill.

•There was no system in place to ensure regular feedback was gained from people, relatives and staff. There was no evidence regular audits had been undertaken by the registered provider or previous managers. Following the inspection, we were provided with an action plan but there was no evidence this had been followed up or identified actions addresses.

•Where things went wrong, prompt action had not been taken to reduce the risk of future incidents. The registered provider had failed in their legal duty to notify the Care Quality Commission of incidents which placed people at the risk of harm or resulted in the person being injured.

•During the inspection we observed the nurse and care workers to be kind, caring and respectful. People were supported to engage in a range of activities. Meal times were pleasant with people being offered choice, where people needed support, this was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

•People’s care records were person centred and detailed, although we identified some areas where improvements were needed to people’s records.

Rating at last inspection:

•This is Angel Court’s first inspection since its registration on 29 May 2018.

Why we inspected:

•This inspection was brought forward in response to concerns raised by the local authority regarding the lack of management stability at the home, the lack of management oversight by the registered provider and concerns about the financial stability of the registered provider.

Enforcement:

•The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

•Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

•If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will act in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to 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 so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

•For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

•During this inspection, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, related with staff recruitment, staff training and good governance. You can see what action we told the provider to take at the back of the full version of the report.

•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 continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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