Background to this inspection
Updated
22 June 2022
We last inspected this service in December 2018 in response to concerns. During the last inspection, the service was rated requires improvement in all areas with breaches to regulation identified.
This inspection was also prompted as a result of an increase of concerns CQC received in relation to the quality of care being provided. At this inspection we found limited improvements had been made and there were continued breaches to regulations.
St James Hospital Wards J30 & J31 located at the Beckett Wing are operated by Villa Care Limited who provide nursing care to patients under a service level agreement with a neighbouring trust.
Patients admitted to these wards are medically optimised for discharge from acute hospital wards. The provider works with the local Clinical Commissioning Group (CCG) to ensure patients receive and access care and treatment from a multi-disciplinary team of professionals, some of whom are employed by the trust such as therapy staff. Medical cover is provided by local General Practitioners (GPs) in accordance with agreed contracts.
Villa Care Limited operate ward J32 which acts as a winter pressure ward. We inspected this ward during this inspection as this was still open.
Updated
22 June 2022
We rated this service as overall requires improvement with safe rated as inadequate.
The reasons for the rating of requires improvement overall was as follows:
Risk assessments did not always capture key information and staff did not always follow risk management plans. This included risks such as falls, deterioration in physical health and pressure care.
We did not always find the environment and equipment was safe, clean or well managed.
People were not always encouraged to be as independent as possible and there was a lack of person-centred care being provided. For example, patients did not have access to sufficient levels of meaningful activities and were often bored. Also, patients were not encouraged to get dressed during the day or supported to use the toilet rather than a bedpan where this was possible.
We received mixed feedback from carers, some concerned at the deterioration in their relatives.
Records we reviewed did not always contain adequate information required to ensure safe and high-quality care was provided. For example, in some cases patients’ weights were not adequately monitored and this was potentially unsafe if changes in weight were not addressed.
We received mixed feedback from stakeholders about the way the service operated.
Leaders and managers ensured quality assurance processes were in place however these were not always effective in addressing shortfalls in the quality of care provided.
However:
We did find that patients were not left for long periods of time when they required assistance, call bells were responded to efficiently by staff.
Staff who were employed by Villa Care spoke positively about the service and the relationships with other teams and professionals.
Staff were recruited safely.
We found managers worked closely within a network of other organisations to review and respond to pressures within the system.
Patients told us they felt safe and were mainly positive and complimentary about the care they received as well as the food choices available.
Leaders were visible and approachable, and staff felt they had the right support.