Archived: Palace House Care Home

Updated 9 September 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Palace House 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 both were looked at during this inspection.

The service had a manager registered with CQC. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at the information we held about the service. This information included statutory notifications the provider had sent to CQC. A notification is information about important events which the service is required to send us by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also spoke with local authority commissioners for their views about the service. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spent time in the communal areas observing how staff provided support for people to help us better understand their experiences of the care they received. We spoke with nine people living in the home and with 3 relatives. We also spoke with the registered manager, the clinical nurse lead, three care staff, the activity person and a healthcare professional.

We had a tour of the premises and looked at a range of documents and written records. These included three people's care and support records, two staff recruitment records, training and supervision records, staff rotas, minutes from meetings and complaints and compliments records, maintenance and servicing certificates and records related to the auditing and monitoring of service. We also looked at the recent monitoring report from the local authority.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 9 September 2021

About the service

Palace House Care Home is a residential care home providing personal and nursing care to 33 people. At the time of the inspection, there were 33 people living in the home.

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

People felt safe. They said staff were kind and helpful and they were treated well. People and their relatives were happy with the service they received. Staff understood how to protect people from abuse and recruitment processes ensured new staff were suitable. There were enough staff to meet people's needs and to ensure their safety, although people’s views varied on this. People’s medicines were managed safely. People received their medicines when they needed from staff who had been trained and had their competency checked. We discussed areas for improvement such as ensuring opening dates were recorded to all boxed and bottled medicines. Any risks to people’s safety and well-being were assessed and recorded; clear guidance was provided for staff and any changes in people's health and well-being were referred to healthcare professionals as appropriate. Infection control was well managed, and the home was clean, maintained and free from odours. We discussed areas for improvement such as the lift flooring and walls and doorways in need of attention. However, there was a development plan available to support improvements.

People, their relatives, visitors to the home and staff told us the service was managed well. Staff enjoyed working at the home. The home worked in partnership with other organisations to provide safe, effective and consistent care. People were treated as individuals and their diversity was respected. People's care was tailored to their needs and preferences and staff knew people well. There were effective systems to assess and monitor the quality of the service and the practice of staff. People's views and opinions of the service were sought and acted on. The registered manager promoted an open culture in relation to accidents and incidents. There was clear evidence of changes to practice and lessons learned from any incidents.

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 11 September 2019).

Why we inspected

The inspection was prompted in part by notification of a specific incident and concerns in relation to failure to seek prompt medical advice. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. We found lessons had been learned and measures had been put in place to improve the service provided.

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 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 Palace House 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.