Background to this inspection
Updated
27 February 2021
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 Care Act 2014.
Inspection team
The inspection team was made up of two inspectors. One inspector conducted telephone calls to both staff and relatives of people using the service and the other attended the service and conducted the site inspection.
Service and service type
Roman Wharf Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. However, they were no longer in post. There was a manager who was in the process of applying for their registration.
Notice of inspection
We gave the service 48 hours’ notice of the inspection to ensure we could obtain relevant information relating to peoples and the inspector’s safety.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We requested information about the service, relating to staffing levels, governance and oversight. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with seven members of staff including the provider, manager, deputy manager, care workers and the chef.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies relating to the management of COVID-19 and quality assurance records. The provider also sent us an action plan of the immediate improvements they have made.
Updated
27 February 2021
About the service
Roman Wharf Nursing Home is a residential care home that provides accommodation and personal care, including nursing for up to 50 people, some of whom were living with dementia. There were 36 people using the service at the time of our inspection.
People’s experience of using this service and what we found
Some incidents which took place in the service had not always been identified as safeguarding concerns and escalated to the local safeguarding team.
Systems and processes which had been implemented to monitor potential safeguarding concerns in the service had not been used effectively.
Medicines had improved. However, further improvement was needed. There were occasions where people did not always receive their prescribed medicines. Records were not always up to date with people’s personal information.
Staff understood their responsibility to keep people safe and knew how to report concerns.
Safe recruitment processes were followed to ensure staff were suitable to work with people using the service.
Risks associated with people’s care had been identified, mitigated and monitored.
Infection Prevention Control measures were in place to reduce the risk of infection to people.
The registered manager was no longer in post. A new manager had taken over the running of the service and staff were unsettled but hopeful they would see changes being made. The new manager was in the process of registering with CQC to become the registered manager.
The provider had oversight of the service and carried out regular visits to monitor the quality of people’s care.
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 17 October 2019) and there were breaches of regulation. 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 some improvements had been made and the provider was no longer in breach of one regulation. However, at this inspection we identified a breach in relation to Safeguarding.
This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 22 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. This was regarding safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 coronavirus and other infection outbreaks effectively.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed from requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Roman Wharf Nursing Home on our website at www.cqc.org.uk.
Enforcement
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, we will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified an ongoing breach in relation to governance. We also identified a breach in relation to Safeguarding. 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.