Regency Care Home

Updated 7 September 2023

The Inspection

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 12, (1), Safe care and treatment, Regulation 17, (1), Good governance, and Regulation 18, (2), Staffing, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection team

This inspection was carried out by 2 inspectors

Service and service type

Queensferry Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was no registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including feedback from the local authority. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

The purpose of this visit was to check the provider had met the warning notice issued at the last inspection. This meant our focus was on checking people’s care plans and monitoring records, medicines management, staff training and audits completed by the management team. We also spoke with 2 people who used the service and 1 person’s relative. We spoke with 4 members of staff including the acting manager, deputy manager, a senior care assistant and a care assistant.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed a variety of audits that were sent to us by email, relating to the management of the service. We also reviewed staff training records.

Updated 7 September 2023

About the service

Queensferry Court Care Home is a care home providing personal and nursing care to up to 56 people. The service provides support to people with a physical disability, sensory impairment, mental health needs and older people, including those with dementia. At the time of our inspection there were 39 people using the service. Within the home there are 3 wings, split over 2 floors with communal lounges and dining areas. People have access to a secure outdoor area.

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

People were not always protected from the risk of harm. Records were not always accurate or complete which meant staff did not always have guidance to support people safely. The home was not cleaned to a high standard, well maintained or free from environmental risks. Not all staff knew how to raise a safeguarding, or where to find this information. Lessons were not always learned when things went wrong and staff did not always recognise when accidents, incidents or near misses should be reported. Medicines were not managed safely, and people did not always receive their medicines as prescribed.

Lack of oversight and poor governance systems meant some risks, or areas for improvement, were not always identified and acted on quickly. Staff did not receive clear guidance or direction to understand their roles and responsibilities which impacted on people’s outcomes.

Staff were not suitably trained to carry out their roles. People were placed at risk of malnutrition and dehydration. Staff worked alongside relevant healthcare professionals; however improvements were required to ensure staff were clear on recommendations to follow to help improve people’s health outcomes. Not all areas within the home were dementia friendly, or accessible.

People’s holistic needs were assessed prior to moving into the home, which included nationally recognised evidence based tools. 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, relatives and staff had some opportunities to feedback into the running of the service. The provider was working alongside partner agencies to improve safety to people using the service.

Staff were recruited safely, and there was enough staff deployed at the service.

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 30 April 2021).

Why we inspected

We received concerns in relation to the management of pressure care, food and fluid monitoring and oversight at the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing, nutrition and hydration and governance at this inspection.

Please see the action we have told the provider to take at the end of this 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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 with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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.