Puttenham Hill House Care Home

Updated 1 October 2021

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

Our inspection was completed by two inspectors.

Service and service type

Puttenham Hill 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 unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We received feedback from the local authority and professionals who work with the service. The provider was in the process of completing a provider information return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection-

We spoke with four people who used the service about their experience of the care provided. We also observed care and interaction between people and staff. We spoke with seven members of staff including the registered manager, area director, nursing staff and care staff.

We reviewed a range of records including care plans and daily notes for people and multiple medication records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies, audits and meeting minutes.

Updated 1 October 2021

About the service

Puttenham Hill House Care Home is a residential care home that provide personal and nursing care for up to 30 older people who may be living with dementia and or a physical disability. The home accommodated people across three separate units. At the time of our inspection the service was providing care to 23 people.

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

Staff were not deployed effectively at the service which left people at risk. Although staff were aware of the risks associated with people’s care this was not always being managed in a safe way. Quality assurance was not always effective. The provider had failed to maintain robust oversight of the service. As a result, the level of care had deteriorated from the last inspection.

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. People had access to health care professionals to support them with their care. People and relatives told us that staff were kind and caring and we saw examples of this.

Safety checks were undertaken at the service and there were plans in place to protect people in the event of a fire. People received their medicines when needed. Staff were aware of the procedures of reporting safeguarding concerns and people told us they felt safe with staff. People were given opportunities to feedback how they wanted their care to be delivered.

Rating at last inspection (and update)

The last rating for this service was Good (published 25 October 2018). At the latest inspection we found breaches of three regulations.

Why we inspected

The inspection was prompted in part due to concerns received about unsafe staff levels which was impacting on the care being provided to people. A decision was made for us to inspect and examine those risks.

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 COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective 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 report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risks related to staffing levels, safe care being provided to people, people being at risk of social isolation, people being supported with adequate nutrition and hydration, and the lack of robust provider and management quality assurance at this inspection.

For requirement actions of enforcement which we are able to publish at the time of the report being published. 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.