Poldhu

Updated 7 December 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

This inspection was carried out by two inspectors and a member of the medicines team.

Service and service type

Poldhu 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 did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A new manager was in the process of registering with the Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 of this information to plan our inspection.

During the inspection

We spoke with five people, the new manager, the new clinical lead, the clinical matron, the HR manager and the operations manager. We spoke with three relatives and eight staff.

We reviewed a range of records. This included nine people’s care records and 12 medication records. We looked at the most recently recruited staff file in relation to recruitment. We reviewed staff training and supervision. A variety of records relating to the management of the service were reviewed.

After the inspection

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

Updated 7 December 2021

About the service

Poldhu is a residential care home providing personal and nursing care to 63 people aged 65 and over. At the time of this inspection 40 people used the service. Poldhu is part of the Swallowcourt group which has two other nursing homes in West Cornwall.

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

The service had suitable safeguarding systems in place, and staff had received training to help them to recognise and know what to do if they suspected abuse was occurring.

Relatives told us they were happy with the care their family member received and believed it was a safe environment. Comments included, “Yes, it all seems very good. The place is very clean and does not smell at all. (Person’s name) is very happy here.”

Care plans were managed on a recently implemented electronic system and included risk assessments and guidance for staff on how to meet people’s support needs. Risk assessment were satisfactory and any risks to people were minimised.

Due to recent staff shortages and a period of inconsistent leadership, the effective implementation of this system had been delayed. Senior management were aware of the recent challenges at the service, and the impact of staff shortages and changes in management and had been providing additional support.

Medicines were managed on an electronic system. People were given their medicines safely. People’s medicine support needs had been assessed and were recorded in care plans. Care plans included additional risks related to medicines. Some prescribed creams had not always been recorded.

At this inspection we found some gaps in care and medicine records and have made recommendations about this in the report.

Staff were recruited safely. There were sufficient numbers of staff to ensure people’s needs were met. Although, there had been a couple of shifts when staffing levels had dropped below planned levels, due to short notice sickness absences, which could not be covered by other staff or agency.

There were sufficient trained and qualified staff on duty to meet people’s needs. Many staff had been provided with supervision this year, although this had not been as regularly as planned due to the impact of recent staffing pressures and the challenges of the pandemic. We saw a more robust programme of supervision and competency checks was being implemented for all staff.

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 who wished to remain in their bedroom did so. Those spoken with confirmed this was their choice.

People enjoyed the food provided and confirmed they had choices provided. Comments included, “Yes, the food is fine. We can choose what we want and there is plenty of it.”

The building was clean, and there were appropriate procedures to ensure any infection control risks were minimised. Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Suitable visiting arrangements were in place for families to visit as per new government guidance.

The service has experienced a period of time without a registered manager. However, a new manager had been recently recruited along with a new clinical lead. Both had joined the service in the last few weeks. They were being supported by the clinical matron and the operations manager at the time of this inspection.

Staff morale had suffered recently due to staffing shortages and the pressures of the pandemic. Although staff we spoke with at this inspection told us things had improved and they were working well together. They told us, “Things are getting better, we are getting more support” and “The new manager helps us on the floor and they are being given support so we all benefit.”

There were appropriate audit and quality assurance systems in place. Senior management had recently implemented a new monitoring system which provided them with effective oversight of the service.

Any changes in people’s health were escalated to the relevant professional and relatives were kept informed. Suitable mobile lifting equipment and mobility aids were in place to meet people’s needs.

People, and their relatives were asked for their feedback on the service’s performance. There was a stable staff team who knew people well and worked together to help ensure people received a good service.

Any concerns raised by people or their families were recorded, investigated and responded to appropriately.

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 (report published 4 January 2019).

Why we inspected

We received concerns in relation to low staffing levels and a lack of stable management. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 coronavirus 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Poldhu on our website at www.cqc.org.uk.