Background to this inspection
Updated
15 August 2023
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 Health and Social Care Act 2008.
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
There were 3 inspectors on this inspection 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
Thameside is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Thameside is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 4 people who used the service and 10 family members. We spoke with 9 members of staff including the registered manager. We reviewed a range of records. This included an in-depth review of 6 people's care and medicine records and an overview of 6 others. We looked at staff files in relation to safe recruitment practices. A variety of records relating to the management of the service and quality assurance were reviewed including accident and incident records and audits. We sought feedback from healthcare professionals who work with the service.
Updated
15 August 2023
Thameside is a residential care home providing personal care to up to 61 people who live with physical frailty and dementia. The service is divided in to 5 units across 3 floors. At the time of our inspection there were 49 people using the service.
People’s experience of using this service and what we found
The governance systems of the service did not support the service to consistently improve and sustain safe care delivery. There were quality assurance processes in place, but these did not always identify areas for improvement including potential risks to people's safety and environmental issues.
We made a recommendation about the variety of available activities. Care plans were in place for people which set out how to meet their needs in a person-centred way. Information was provided to people in a way that was accessible to them. Systems were in place for dealing with complaints, and complaints were dealt with in accordance with the provider’s complaints policy.
The service had enough appropriately skilled staff to meet people's needs and keep them safe. People and relatives told us there were sufficient staff to care for their family member. However, some staff felt staffing levels in certain areas of the home would benefit from more staff. The provider had a safe staff recruitment process in place. Staff received appropriate training, support and development which enabled them to meet people's needs.
People’s needs were assessed before moving into Thameside. This was to ensure the service could meet these needs. People received care and support from staff who had were appropriately recruited and trained to recognise signs of abuse and how to safely support people. Staff understood people’s risks and ensured people had as much choice and control of their lives as possible.
Referrals were made appropriately to outside agencies when required. For example, GPs, community nurses and speech and language therapists. Notifications were completed to inform CQC and other outside organisations when events occurred. Healthcare professionals told us staff were knowledgeable about people's healthcare needs and followed their recommendations.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. They were supported with their nutritional needs. Specialist diets were in place when required and people were monitored to help them retain a healthy weight. Their health care needs were monitored, and staff ensured when support from external health professionals was required this was sought in a timely manner.
Family members spoke positively about staff engagement with their relatives and told us they were treated in a caring and respectful way. People and their relatives had the opportunity to express their views on their care and staff worked in a way which supported people's dignity and privacy.
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 09 November 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.