We carried out a review of the data available to us about Quebec Hall Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Quebec Hall Limited, you can give feedback on this service.
Quebec Hall accommodates people in a large listed building. There are spacious grounds for people to enjoy which also contain a number of sheltered bungalows which do not form part of the provider's current registration.
We found the following examples of good practice.
People lived in a large, relaxed service with regular access to outdoor and space personal space. They were supported by regular staff and no temporary staff were used. This enabled staff to provide continuity of care.
People received support to meet their spiritual needs. As a Christian home people had regular opportunities to celebrate and practice their faith. This helped support people emotionally and alleviate some of the isolation people could experience during COVID- 19.
Risk assessments were in place to document any risks to people or staff who might be particularly vulnerable should they acquire an infection. Staff and people were fully vaccinated except for one person who had declined. This was clearly documented.
Staff were observed wearing, regularly changing and disposing of PPE correctly to reduce the risk of infection.
Visitors to the service were welcome, subject to a negative lateral flow test, normal temperature and adherence to wearing the correct PPE and social distancing. Up to three visitors a day were allowed, and the visitors policy was reviewed in line with changes to government policy.
The environment was well laid out with no clutter and regular cleaning took place. Although we were confident in the cleaning regimes and the use of PPE, we noted bins were not foot operated and did not have lids which could increase risk of infection. This was communicated to the manager for her urgent consideration. We found cleaning products stored in cupboards which were not locked. This could pose a risk to people if cleaning products were ingested.
We also found lateral flow tests were being used in line with government guidance, but staff were not routinely completing PCR tests which meant government guidance was not followed and increased the risks of infection being present without detection.
Quebec Hall accommodates people in a large listed building. There are spacious grounds for people to enjoy which also contain a number of sheltered bungalows which do not form part of the provider’s current registration.
We found the following examples of good practice.
Due to COVID-19, external religious speakers had been unable to conduct Christian meetings within the service. A person who received support had taken this duty upon themselves and had conducted these services to their fellow house mates. This ensured the spiritual needs of the individuals had been continued.
Staff were observed wearing Personal Protective Equipment (PPE) in line with current government guidance. PPE was doffed within each individuals bedroom following support and disposed of appropriately to reduce the risk of cross contamination.
All people who had chosen to have the COVID-19 vaccination had done so, ensuring their mental capacity had been assessed prior to this process.
Robust risk assessments had been completed for both the people supported and the staff team. This ensured that all known risks had been assessed in relation to COVID-19 on a personal basis.
All areas within the service were clean and clear from clutter. Cleaning records reviewed evidenced regular cleaning of all areas, including higher risk touch points.
Quebec Hall is a residential care home and was providing accommodation and personal care to 21 people at the time of the inspection. The service can support up to 22 adults.
Quebec Hall accommodates people in a large listed building and has some additional rooms which have been added more recently. There are spacious grounds for people to enjoy which also contain a number of sheltered bungalows which do not form part of the provider’s current registration.
People’s experience of using this service and what we found
People who used the service, and relatives, were very happy with the care and support provided.
Staff showed a good understanding of consent issues but some paperwork relating to consent needed to be reviewed to ensure it always reflected best practice. We have made a recommendation related to reviewing elements of the service’s consent procedures.
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.
Staff were skilled and well trained. People’s healthcare and dietary needs were met. The environment was homely and suitable for the people who used the service.
Risks were assessed and well managed. The challenges of the building did not place people at any additional risk but would need to be kept under review. Health and safety checks were in place and action followed very promptly when issues were identified. Staffing levels were good and staff had time to meet people’s needs. Staff were safely recruited. Medicines were well managed, and staff were clear about safeguarding concerns and how to raise issues.
Staff were kind and caring towards the people who used the service and their relatives. They promoted people’s independence and upheld their dignity. The environment was warm, caring and welcoming. The Christian ethos of the service was central to the way care was delivered and people were very positive about this. People who used the service were included in decisions about their care and played an active role in their local community if they wished to.
The service provided people with meaningful occupation and enabled them to follow their own hobbies and interests. Activities were varied, appropriate and inclusive. End of life care was well managed, and staff had received training to enhance their skills in this area. There was a complaints procedure in place, but no complaints had been received.
There was strong leadership from the registered manager who worked closely with the general manager. Trustees of the charity carried out an effective quality assurance role and provided support to the management team. There was very good oversight of health, safety and welfare at all levels. Staff throughout the service were passionate about their role and committed to providing good quality care.
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 02 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
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.
This unannounced inspection took place on 27 October 2016.
At the last inspection on 24 August 2015 breaches of legal requirements were found. After the comprehensive inspection the provider wrote to us to say what they would do to meet the legal requirements. The provider sent us an action plan telling us how they would make the required improvements. During this inspection we found that the provider had made the necessary improvements and all legal requirements were now being met.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 scheme is run.
Although people were supported by staff with their prescribed medicines people could be at risk because some records were not up to date.
An induction process was in place to support new staff. Further training was provided to ensure all staff had the necessary expertise and skills to meet the needs of people living in the service.
People were involved in their care assessments and reviews, which meant staff knew how to provide the care and support they needed. People were supported to be as safe as possible because assessments of risks had been completed, although the details of how the risks could be managed had not always been recorded.
The risk of harm for people was reduced because staff knew how to recognise and report any incidents of harm. There was a sufficient number of staff to meet the care and support needs of people living in the service. Satisfactory pre-employment checks were completed before staff worked in the service.
The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed. Staff were trained in the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and could describe how people were supported to make decisions. Although no-one in the service was currently deprived of their liberty, applications had been made to the relevant authorities in the past to ensure that people’s rights were protected if they lacked mental capacity to make decisions for themselves.
People were able to make choices about their food and drink throughout the day. Staff checked that people had sufficient amounts to eat and drink. Staff treated people with care and respect and made sure people’s privacy and dignity was respected all the time.
People and staff were able to provide feedback and information so that the management could monitor and improve the quality of the service. The registered manager had an open door policy which meant that people and staff could make any comments/improvements about the care and support provided.
Quebec Hall Limited is a care home providing accommodation and personal care for up to 22 older people who are Christians, some of whom are living with dementia. There were 21 people living at the home during our inspection. The provider is a registered charity operating under a deed of Trust and operated by a Board of Trustees. The home is a listed building with en-suite bedrooms over three floors, communal areas over two floors and communal gardens.
This unannounced inspection took place on 24 August 2015.
Our last inspection took place on 7 April 2014 and as a result of our findings we asked the provider to make improvements to staffing checks. We received confirmation from the registered manager that improvements had been made. During this inspection we found that the necessary improvements had been made and staff were only employed after satisfactory pre-employment checks had been obtained.
The service had a registered manager in place. 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.
Staff were aware of the procedures for reporting concerns in order to protect people from harm. However, although policies were in place to ensure people’s safety was assessed and effectively managed, these were not always followed and not all risks were assessed. In addition, people could not be assured that their nutritional and hydration needs would be met.
The CQC monitors the operations of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. People’s rights to make decisions about their care were respected. However, staff were not aware of their responsibilities under the MCA and DoLS to support people who did not have the mental capacity to make decisions.
Care records did not provide staff with sufficient guidance to enable them to consistently provide care that met each person’s needs. People were offered ‘event’ type activities, such as entertainers and group activities, such as quizzes. In addition friendships and individualised activities that focused on people’s interests or hobbies were encouraged. People were supported to manage their prescribed medicines safely and medicines were stored in a safe way.
People received care and support from staff who were kind, friendly, caring and respectful. Staff respected people’s privacy and dignity. People’s religious beliefs were respected. There were sufficient staff to ensure people’s needs were met safely. Staff were trained and well supported by their managers.
The registered manager was supported by senior staff, care workers and ancillary staff. The registered and general manager’s, were approachable. People’s views were listened to and acted on. People and relatives were encouraged to provide feedback on the service in various ways both formally and informally. However, there was a lack of quality assurance which meant that areas that needed improving had not all been identified.
We found a number of breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People are treated with respect and dignity by the staff. People told us they felt safe, we saw that staff had received updated safeguarding of vulnerable adults and that the provider had safeguarding procedures in place.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.
The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.
We looked at the recruitment of new staff. This showed that some required recruitment checks relating to obtaining references were not in place. This put people at risk of being supported by staff without the appropriate background checks having been carried out.
We have asked the provider to tell us what they are going to do to meet the legal requirements when recruiting staff.
Is the service effective?
People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs.
People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'The staff are very good'. A visiting GP said 'The staff were very caring and knowledgeable about people's needs'.
People using the service, their relatives, friends involved with the service completed a satisfaction survey. Where shortfalls or concerns were raised these were addressed.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People's needs were assessed before they moved into the service and they were offered the opportunity to visit the service on as many occasions as they wished prior to making any decisions about the suitability of the service.
Peoples views on the quality of the service provided were regularly sought by the provider. This information was used to identifies areas of improvement and identify what was working well.
Records confirmed that information relating to people's preferences and interests were sought and that people regularly had access to a range of activities of their choice in and outside of the service.
People knew how to make a complaint if they were unhappy. People we spoke with told us that they were aware of how to make a complaint and to whom. The service has not received any complaints since the last inspection.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. A GP told us that they receive appropriate referrals for people who use the service and that the staff were very cooperative.
The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. The service is currently reviewing how it conducts customer surveys to ensure that customer feedback is received more frequently.
Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.
We observed lunch time during our inspection and found that staff offered encouragement and assisted people as necessary. People were provided with lunch of their liking and staff were aware of people's preferences in relation to portion sizes. One person we observed liked to take a long time over their meals and we saw that this was appropriately referenced in their care plan. Staff were patient with this person and allowed them to eat at their own pace.
There were appropriate arrangements in place to safely manage people's medications.
We spoke with three members of staff who confirmed that they felt appropriately trained and supported to carry out their role. Our review of records confirmed that appropriate training courses were provided to staff and that they benefitted from a regular system of supervision and appraisal.
The inspection team was led by a CQC inspector and an 'expert by experience' (people who have experience of using services and who can provide that perspective).
We spoke with a total of seven people who were using this service. People spoken with reported that they felt respected and involved by staff. For example, one person told us that 'I'm treated with both dignity and respect' and another person told us ' I come and go as I please, today, I've been to the village'
We also spoke to four visitors of people who were using this service. They confirmed that they were consulted with about the care that their relatives were receiving and felt able to talk to senior staff if they had any concerns. One visitor spoke highly of the individual attention shown by staff towards their relative and another visitor stated that the home had an open door policy and were always happy to support them and their relative. Another visitor spoken with reported that "the staff are absolutely brilliant, they always make me feel welcome and they are very attentive to my friend'.
People using the service reported that they enjoyed the meals provided and that the food was good. They also confirmed that people were offered help as needed and that their individual choices were respected by staff. For example one person told us 'mealtimes are enjoyable'.
People spoken with reported that they felt safe in the service and that the staff were kind and attentive. For example one person told us, 'I feel very safe here, staff are very kind to me', then, having assured us there was no abuse, they told us that they had 'no concerns about ill treatment, staff always have time for me'. Another person told us, 'I have no concerns but if I had I would speak to staff and I am confident they will help me'.
People stated that their call bells were answered promptly and that if they needed any assistance staff were helpful.
Visitors spoken with reported that there were always plenty of staff around and that they were supportive towards the people using this service.
Six out of seven people knew that their records were kept in the office and all knew they were regularly updated. The one person who wasn't sure said 'I don't know where my records are kept, but the staff will know'.
People with whom we spoke confirmed they would speak to staff if they had a complaint.