Regents Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe - This means we looked for evidence that people were protected from abuse and avoidable harm. We assessed a total of 8 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was inadequate. At this assessment significant improvements were found and the provider was no longer in breach of the regulations and this key question has changed to good. However, we did find that more regular checks were required to ensure safety aspects such as window restrictors remained in good working order and in line with current legislation. People felt safe and supported by the staff. Staff understood their responsibilities and how to keep people safe and knew how to report concerns. The registered manager understood their safeguarding responsibilities and how to protect people from abuse. People's care had been planned and potential risks to people had been identified, with mitigation in place to protect people from potential harm. There were enough staff on duty to keep people safe and meet their needs. People's medicines were managed and stored in a safe way. The home was clean and staff followed safe infection control practices.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s experience of care and support had significantly improved because the provider now listened to their concerns and addressed them promptly. One relative told us, “The difference in the last 6 months is phenomenal and I’m so grateful to the new management team and staff, they’ve really turned the home around”. While another relative told us, “[Registered Managers name] often asks me if there is anything they can do to improve or make [person living at the home] life more enjoyable.”

Staff were aware of how to respond to accidents and incidents which included how to record and report incidents. The registered manager confirmed that all accidents and incidents are reviewed for lessons learned.

The provider had systems in place to continually identify concerns, ensure these were investigated and learnt from, to help reduce the risk of them from happening again. For example, where a person had experienced a fall, the registered manager reviewed this to make changes to the support offered to the person to reduce the risk of this from happening again.

People had reviews with external health and social care professionals to ensure their overall healthcare needs were being met.

Staff understood people’s individual risks and were able to share their knowledge and understanding of this with health care professionals who were involved in people’s care. For example, staff were able to update the community nurses with up to date information about how a person was doing after their treatment.

Care and support was planned and organised with people, staff who supported them and where appropriate their relatives, along with external health and social care agencies ensure continuity.

The providers policies and processes for safety were aligned with other external agencies who were involved in people’s care journey to enable shared learning and drive improvement.

All people we spoke with told us they felt safe by the staff who supported them. Relatives also felt their family member was kept safe. One relative said, "I no longer worry about leaving [person’s name] when I go home at night." While another relative said, "[Person’s name] is happy and is always well presented and content when I visit. I can’t fault the care.”

Staff received training on how to recognise and report abuse and knew the processes to follow to keep people safe. All staff felt confident to raise concerns with the registered manager, one staff told us, “[Registered manager’s name] is really approachable and listens to me.” All staff were confident any issues raised with the registered manager or provider would be fully investigated to make sure people were protected. Health and social care professionals confirmed that where safeguarding concerns had been raised, the registered manager had taken prompt action to safeguard people and notify relevant agencies, and where appropriate the person’s relative. The provider and registered manager understood their responsibilities regarding the action to take to protect people from harm and took action to protect people where required.

During the site visit we saw kind and respectful interactions between people and staff. Staff were seen to offer people choices and seek consent before supporting.

The provider’s safeguarding policy gave clear guidance for staff about how to raise a safeguarding alert. Any safeguarding concerns were recorded appropriately and reviewed to ensure the relevant professionals were notified. Where the registered manager had deemed people were being deprived of their liberty, applications had been sent to the local authority for authorisation. They kept track of application processes, to ensure key dates were met. The registered manager met their legal requirement to notify the CQC where a person had been legally deprived of their liberty.

Staff, together with people, assessed individual risks to ensure people remained safe. Relatives felt staff knew how to keep their family member safe, and were involved in their family members care, with any changes or incidents also being communicated well. One relative said, “Tough time late last year, [person’s name] wasn't well at all and care wasn’t brilliant. Since new [registered] manager started it’s been wonderful.”

Staff recognised risks to people and were consistent in their knowledge as to how they supported people.

People were supported to do the things they wanted to do, and staff helped them to do this safely. We saw staff supporting people safely around the home and in activities. Staff were patient and supported people at their own pace. When one person became distressed staff were quick to intervene, give reassurance.

The registered manager used the new electronic care record system to regularly review what care and support people had received. They told us that if there had been an incident or a change in someone’s health recorded by care staff, it would alert them to the change and that a review was required. In addition to this, staff also completed regular reviews to ensure care plans and risk assessments remained relevant and up to date. People’s care plans and risk assessments were personalised to them. Details held within the records we looked at showed a very good understanding of the person’s needs and how to meet these.

People did not express any concern in relation to the safety of the environment. People had access to a secure garden area and a choice of communal areas to sit in throughout the day. Key coded access meant people were secure in the home in line with the best interests. Relatives felt the environment of the home was safe but needed cosmetic work. One relative said, “We know the environment could do with a little bit of TLC but hopefully this will improve when the [CQC] rating changes and people can move in.”

Staff were clear what their responsibilities were in relation to the upkeep of the home. The registered manager recognised there were some areas of the home which required improving for aesthetic reasons, however this did not impact on people’s safety.

We found there was 1 bathroom window and 2 skylight windows which did not have the required window restrictors in line with the Health and Safety Executive (HSE) requirements. We notified the registered manager of this, who confirmed this had been rectified after our site visit. We also found some radiator covers and fire extinguishers were loose and not fully secured to the wall.

Maintenance was mostly well managed and there was clear information to demonstrate services and system checks were completed. However, more robust checks were required to ensure installed safety aspects remain in good condition, for example, to check all window restrictors to see if any had been damaged and needed replacing.

People did not raise concerns about staffing levels with us and told us the staff were attentive to their needs. Relatives felt there were enough staff on duty to meet their family member's needs. One relative said, " I think there are more than enough staff on shift and they seem to know what they are doing now.”

There had been a significant change in the care staff group since our last inspection. The registered manager told us there had been a higher use of agency staff due to this. However, they confirmed that over the last few months agency staff usage had stopped, as they had a full complement of staff. Staff told us there was enough staff deployed to meet people's needs and keep people safe. Staff had received training to ensure their knowledge was up to date and in line with best practice. Staff felt this training had benefited them to provide safer care. Staff told us the training and support had improved. A new staff member told us they had an induction period before they began supporting people. Staff had received practical training from external sources such as manual handling. Online training also took place for other areas, such as safeguarding and infection prevention and control.

Staff were attentive to people's needs and requests and supported people at their own pace. Staff were visible in communal areas and responded to call bells and requests for support promptly. The staff we met at the home were experienced in their roles.

The registered manager used a dependency tool to determine staffing levels based on people’s support needs. It was recognised by the registered manager that there were only 25 people living in the home at the time of our visit. The registered manager recognised they would need to continue to monitor staffing levels and deployment of staff, when occupancy increased, to ensure standards remained at a good level. The registered manager completed supervisions and spot checks to test staff's knowledge and observe if they applied this in practice or whether further training and support was required. The provider followed safe recruitment procedures before staff began working in the home.

People were protected from the risk of infection as staff were following safe infection prevention and control practice.

Staff had access to personal protective equipment (PPE). Cleaning staff told us they had enough cleaning equipment to support them to carry out their roles effectively. They told us they had a cleaning schedule they followed, so that no rooms were forgotten.

The home appeared clean and clutter free. The laundry room was seen to be clean and well organised. However, there were some areas which required further cleaning to ensure a build-up of dirt did not accumulate over time, for example, on wall decorations and under fixed furniture.

Regular audits were undertaken to ensure the areas of the home were maintained.

People and relatives did not raise any concerns around medicines.

Senior care staff had received training in medicine administration, and their competence was regularly checked. Staff told us they had sufficient time to administer medicine, and the medicines were well organised with sufficient stock. Medicine record keeping was clear and accurate. Staff followed safe practice when administering medicine to people. However, we did see during a medicine round the staff member was interrupted by answering telephone calls, supporting a visiting professional and answering the door. We raised this with the registered manager, to ensure this was reviewed to reduce disruption to a minimum, to help mitigate the risk of a potential error.

The registered manager had improved the process of receiving, storing and returning medicines, to be in line with national best practice. The management team complete medicine audits, which included spot checks of staff’s practice, record keeping and medicine counts. Where shortfalls were identified, further training and support was given.