Background to this inspection
Updated
20 May 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 5 April 2017 and was unannounced. The inspection was carried out by one adult social care (ASC) inspector.
Before this inspection we reviewed the information we held about the home, such as information we had received from the local authority and notifications we had received from the registered provider. Notifications are documents that the registered provider submits to the Care Quality Commission (CQC) to inform us of important events that happen in the service. The registered provider was asked to submit a provider information return (PIR) before this inspection and it was returned to us within the required timescale. The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.
During this inspection we carried out observations using the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not communicate with us.
Healthwatch had carried out an Enter and View visit in March 2016 and the comments in their report were positive. Healthwatch is an independent consumer champion created to gather and represent the views of the public.
On the day of the inspection we spoke with three people who lived at the home, two visitors, two members of staff and the registered provider; the registered manager was on holiday. We looked around communal areas of the home and some bedrooms, with people’s permission. We also spent time looking at records, which included the care records for two people who lived at the home, the recruitment records for two members of staff and other records relating to the management of the home, such as quality assurance, staff training, health and safety and medication.
Updated
20 May 2017
This inspection took place on 5 April 2017 and was unannounced. At the last comprehensive inspection of the service in February 2016 we rated the home as Requires Improvement due to breaches in Regulation 12: Safe care and treatment (because of our concerns about poor infection control), Regulation 15: Premises and equipment (due to poor maintenance of the premises) and Regulation 17: Good governance (due to concerns about quality assurance and the unavailability of some records).
At this inspection we found that improvements had been made to the cleanliness and safety of the premises and that quality assurance systems were more effective. This meant that the breaches of regulation identified at the last inspection had now been met. However, there had again been a delay in the registered provider arranging for the gas safety systems to be serviced. We will address this matter outside of this inspection process.
The home is registered to provide accommodation and care for up to 20 older people, including people who are living with dementia. On the day of the inspection there were 15 people living at the home. The home is situated in Preston, a village in the East Riding of Yorkshire but also close to the city of Kingston upon Hull. The premises are on two levels and the first and second floors are accessed by use of a stair lift.
The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were protected from the risk of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.
There was evidence that the registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had received training on these topics and understood their responsibilities.
Care plans were a good reflection of people’s individual needs and how these should be met by staff. There was a lack of consistency in recording on monitoring charts. This had not resulted in any harm to people but had the potential to do so. We observed that the registered provider discussed the importance of accurate recording with staff on the day of the inspection.
People’s family and friends were made welcome at the home. A variety of activities were provided and people were encouraged to take part.
There were recruitment and selection policies in place and these had been followed to ensure that only people considered suitable to work with vulnerable people had been employed. On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs.
Staff told us they received the training they needed to carry out their roles effectively and confirmed that they received induction training when they were new in post. Staff told us that they were well supported by the registered manager.
Senior staff had received appropriate training on the administration of medication. We checked medication systems and saw that medicines were stored, recorded and administered safely.
People who lived at the home told us that staff were caring and that they respected people's privacy and dignity. We saw that there were positive relationships between people who lived at the home and staff, and that staff had a good understanding of people's individual care and support needs.
People told us that they were satisfied with the food provided. We saw that people's nutritional needs had been assessed and individual food and drink requirements were met.
The registered manager was aware of how to use signage, decoration and prompts to assist people living with dementia in finding their way around the home and some progress had been made in providing these.
There were systems in place to seek feedback from people who lived at the home and their relatives. People told us they were confident their complaints and concerns would be listened to. Any complaints made to the home had been investigated and appropriate action had been taken to make any required improvements.
Quality audits undertaken by the registered manager were designed to identify that systems at the home were protecting people's safety and well-being.