Cathedral View House

Updated 20 May 2022

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.

Service and service type

Cathedral View House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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 announced. We notified the registered manager 24 hours before due to the inspection being undertaken outside normal working hours. We needed to be sure essential staff would be on available and there was full access to records.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

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 used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager, manager and deputy manager. Four care staff and cook.

We reviewed a range of records. This included three people’s care records, medication records and a range of audits. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed. We looked around the environment of the nursing home and residential service.

Updated 20 May 2022

About the service

Cathedral View House is a care home that provides personal and nursing care and is currently registered for up to 60 primarily older people. There were 50 people using the service at the time of our inspection. The service comprises of two separate units, one residential, one nursing, separated by a garden area.

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

At the previous inspection we found medicine systems and processes were not robust. At this inspection we found improvements had been made. People received medicines as prescribed. Staff had received additional training in supporting people with medicines. Management had oversight of medicine systems and followed best practice guidelines.

At the previous inspection we found care plans did not always report on when people’s needs changed and information in care plans was not always up to date. At this inspection we found improvements had been made and care planning, reviews and staff understanding of people’s needs were current. Staff told us they had the information they needed to support people. Improvements had been made in auditing systems and processes.

At the previous inspection we found risks to people were not always being monitored and recorded accurately. Staff did not always follow guidance provided, such as when to re-position some people. Pressure relieving mattresses were not always set correctly. At this inspection improvements had been made. There were records showing risks and monitoring of equipment was in place.

At the previous inspection we found infection control measures were not effective. There was no clear system for staff to ensure effective cleaning of equipment. At this inspection we found improvements had been made. There were processes in place to prevent and control infection at the service.

At the previous inspection we found people living with dementia did not have pictorial signage to support them to navigate their environment. At this inspection improvement had been made. Signage for bedrooms, bathrooms and communal areas supported people to navigate around the service independently.

Safeguarding processes were in place to help safeguard people from abuse. Risks associated with people's care had been assessed and guidance was in place for staff to follow. Medicines were safely managed.

The service’s recruitment practices were safe and there were sufficient numbers of staff available to meet people’s care needs. People told us, “If you need them, they come quickly, they are very quick” and a relative said, “The carers, they are amazing”.

People’s capacity had been assessed following the principles of the Mental Capacity Act 2005 (MCA). Where people lacked capacity there had been applications made to the local authority for any Deprivations of Liberty Safeguards that were necessary to keep people safe and protect their rights.

Staff were using PPE correctly and following current infection prevention and control guidance to help keep people safe. All staff had been provided with additional training in relation to the Covid-19 pandemic and arrangements made to enable relatives to safely visit.

The registered manager provided effective leadership. Staff told us they had been well supported and reported the registered manager had made significant improvements within the service.

The service’s quality assurance systems were effective, and action had been taken to address and resolve the breaches of the regulations identified at our last inspection.

Feedback from people and relatives about the service’s performance was valued by the registered manger and any issues raised had been investigated and resolved. The duty of candour was understood by the registered manager and relatives told us the service communicated with them effectively.

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 Requires Improvement. (Published 8 November 2019)

Why we inspected

We undertook this inspection to check previous breach of regulation had been met.