Regents Court Care Home

Regents Court Care Home is a residential care home providing personal care to up to 40 people. The service provides support to people over the age of 65 and people living with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of the service and what we found:

We found evidence during our inspection of multiple breaches of regulation and the need for this provider to make improvements.

People were not always protected from the risk of harm; we found systems were not effective in reducing risks to people from incidents, the spread of infection or the environment. Systems in place to safeguard people from abuse were not robust and processes for learning lessons were not effective in driving improvements.

People's care plans and risk assessments were not robust to ensure safe care delivery. Care records were not always person-centred, accurate and up to date. People were not always supported to access information in an appropriate way for their needs.

Staff recruitment practices and monitoring systems were not always effective to ensure safe care delivery. Staff were not always fully trained, or their understanding and competence checked to ensure they had understood the training and applied this to their practice. Training provided for staff was not meeting their role expectations and some staff's understanding of the Mental Capacity Act (2005) and dementia was limited.

The provider's quality assurance systems and processes were not effective and had not enabled them to assess, monitor and improve the quality and safety of the service. Staff did not have regular formal supervision to receive feedback on their performance, or constructive feedback on how this might be improved. People's health appointments and outcomes were not always recorded fully or accurately. This meant there was no clear record of when people were seen by health professionals or what the outcome of their appointments or visits were.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Systems and processes were not in place to effectively support people in the decision-making process.

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 11 January 2023). 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 the provider remained in breach of regulations.

Why we inspected

When we last inspected Regents Court Care Home on 16 & 17 November 2022, breaches of legal requirements were found. This inspection was undertaken to check whether they were now meeting the legal requirements.

During the inspection we also found there were concerns relating to how the provider had managed people’s changing needs, so we widened the scope of the inspection to become a comprehensive inspection.

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 Regents Court Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people not being treated with dignity and respect, how people's safety was managed, how people were safeguarded from abuse, people's person-centred needs and how the service was run at this inspection.

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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.

Regents Court Care Home is a residential care home without nursing, providing personal care to older people, some of whom live with dementia. At the time of the inspection 35 people were living at the home. The service can support up to 40 people.

Regents Court Care Home accommodates people in one adapted building. People also have the opportunity to spend time in the garden.

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

Potential risks to people's health and wellbeing had been identified and were managed safely, however, improvements in record keeping were needed to accurately record this. People, and where appropriate, their relatives, had been involved with decisions in how to reduce risk associated with people’s care when people had initially moved into the home but relatives told us they had not been involved in formal care plan reviews after this, but was able to speak with staff and management when they wanted to discuss their family members care needs. Improvements were needed around some aspects of infection control practices to reduce the risk of cross infection. Recruitment processes were not always robust to ensure safe employment of new staff.

The provider’s systems were not consistently effective in identifying and driving improvements in relation to the safety of the home environment and maintaining robust recruitment processes. The provider took prompt action when shortfalls were identified, however, systems for keeping up to date with the wider aspect of best practice needed improvement.

People told us they felt safe and supported by the staff who worked in the home. Relatives felt their family members were safe with the staff who supported them. Staff recognised different types of abuse and how to report it. The registered manager understood their safeguarding responsibilities and how to protect people from abuse. There were sufficient staff on duty to keep people safe and meet their needs. People's medicines were managed and stored in a safe way.

People's care needs had been assessed and planned, however further work was required to ensure the care records reflected the most recent changes in people’s care and support needs. Staff had the training and support to be able to care for people in line with best practice. People were supported to have a healthy balanced diet and were given food they enjoyed. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice. 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 supported this practice.

People were supported by staff who treated them well. One person said, “I like it here. I’m very lucky to be here, they look after me well.” Staff treated people as individuals and respected the decisions they made. Staff treated people with respect and maintained their dignity.

People's care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported to engage in activities and interests which were individual to them. People had access to information about how to raise a complaint. People's end of life care needs were met in line with their preferences in a respectful and dignified way.

The registered manager was visible within the home and listened to people and staff's views about the way the service was run. The provider had put checks into place to monitor the quality of the service provision.

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 29 April 2021).

Why we inspected

The inspection was prompted in part due to concerns received about infection control and staffing. A decision was made for us to inspect and examine those risks. While we found some areas were required to improve, we did not find people had come to harm.

Enforcement and Recommendations

We have identified breaches in relation to Regulation 17 Good Governance at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Regents Court Care Home on our website at www.cqc.org.uk.

Regents Court Care Home is a residential care home without nursing, providing personal care to older people, some of whom live with dementia. At the time of the inspection 37 people were living at the home. The service can support up to 40 people.

Regents Court Care Home accommodates people in one adapted building. People also have the opportunity to enjoy spending time in the garden.

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

People told us they were happy living at the home and told us staff were kind. Staff understood risks to people’s safety and worked with people and their relatives to manage and mitigate risks.

Relatives told us a consistent staff team cared for their family members. There were sufficient staff to care for people whose suitability to provide care had been checked. Staff were supported to respond to any concerns for people’s safety and to promote the safe administration of people’s medicines. Infection control practice reflected Public Health England advice.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were comfortable to ask for assistance from staff when they wanted it. Relatives were complimentary about the way the care was provided and the home was managed. Relatives described the culture at the home as being open and they were involved in decisions about their family member’s care.

Staff told us they had opportunities to make suggestions for developing people’s care further and their suggestions were listened to. The registered manager checked the quality and safety of the care provided and systems were in place to develop people’s care further through lessons learnt.

Rating at last inspection

The last rating for this service was Good (published 28 June 2019).

Why we inspected

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 received concerns in relation to people’s safety, infection control, and how the home was managed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains Good. 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 Regents Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.