Archived: Queensway House

Updated 25 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider met the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating under the Care Act 2014.

The inspection was carried out on 01 March 2017 and was unannounced. The inspection team consisted of two inspectors, an expert by experience and a specialist adviser. The specialist advisor had the experience in nursing and healthcare, elderly and mental health care. An expert by experience is someone with personal experience of having used a similar service or who has cared for someone who has used this type of care service.

Before the inspection we reviewed information we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us.

During the inspection we spoke with eight people who lived at the home, two relatives and nine staff members. We also spoke with the registered manager, the hospitality manager, the dementia manager, the regional manager and the provider. We received feedback from health care professionals and the local authority commissioners.

We viewed care plans relating to six people who lived at the home and three staff files. We also looked at other documents central to people’s health and well-being. These included staff training records, medication records and quality audits. We carried out observations in communal lounges and dining rooms and used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us due to complex health needs.

Updated 25 April 2017

This inspection took place on 01 March 2017 and was unannounced. Queensway House is an 80 bedded care home for older people. It does not provide nursing care. There were 54 people living at the home at the time of this inspection. When we last inspected the service on 14 September 2016 the provider was not meeting the required standards. At this inspection we found that some improvements were made but the provider was still not meeting the required standards.

The home had a registered manager. 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 service is run.

At the last inspection we found that there were not always sufficient numbers of suitable staff available to meet people’s needs consistently across all areas of the home. At this inspection we found that staff were not effectively deployed across the home to meet people`s needs effectively and people`s dependencies were not correctly calculated to ensure these were reflected in staffing numbers. Safe and effective recruitment practices were followed to make sure that staff were of good character and had the experience and qualifications necessary for the roles they performed.

Staff were knowledgeable about the risks of potential abuse and knew how to report any concerns they had internally and externally to local safeguarding authorities. Risk assessments were in place to give staff guidance in how to mitigate risks to people`s well-being, however these were not always followed by staff in relation to pressure management and choking risk.

People who lived at the home and their relatives were positive about the skills and abilities of permanent care staff. However they were not as confident in the abilities and skills of the agency staff working at the home. Staff were trained and they felt supported by the management team at the home.

At the last inspection we found that food and fluid records were completed retrospectively, and where people needed their intake monitored, food records did not document the amount people had eaten. We found that this practice had not improved and staff who completed these records were not always the staff who supported people to eat and drink.

Queensway House has had a consistent registered manager, deputy manager and team leaders in post for a long period of time. In this inspection we found that the management team were not effective in Queensway House to implement and monitor the requirements from the inspection we carried out on 14 September 2016.

The standard of cleanliness in the home had improved. Some areas of the home were freshly decorated and there were no unpleasant odours around the home. However we found that the equipment used by staff to assist people with their mobility like hoist and rota stand was not as clean as it should have been.

Most relatives and care staff told us they had been involved, to varying degrees, in the planning of the care and support their family members received when they moved in the home. However, some people could not recall having been involved and their consent was not always accurately reflected in their individual plans of care.

People were cared for in a kind and compassionate way by permanent staff who knew them well and were familiar with their individual needs, preferences and personal circumstances. We saw that most permanent staff members had developed positive and caring relationships with people who lived at the home. They provided care and support in a respectful way, however in many cases people`s dignity was not upheld, their clothes were stained, they had no socks on and their footwear had dried food stains. Staff were not always attentive to clean people`s face and mouth after they assisted them to eat.

People were able to decide how they wanted to spend their days. We saw people on the ground floor engaged in activities around the home, reading newspapers, listening to music and chatting with each other. However people living on the first floor whose dementia was more advanced had little access to other parts of the home.

The system of meetings was not effectively led by the registered manager who was not able to maintain an oversight of the issues within their own home

The registered manager was supported by the provider, the regional manager, the hospitality manager and a dementia manager to implement and sustain improvements to the quality of the care people received in Queensway House. In addition there was support from the local authority, home improvement nurse and the district nurse team to ensure the care and support people received met their health and social needs. However the registered manager failed to ensure that the improvements needed were successfully implemented and sustained.

People’s medicines were not always managed safely. Medicine records were not completed accurately and not always signed by staff when they administered people`s medicines. When we reconciled medicines for people we found that the amount of tablets had not always corresponded with the amount on the medicine administration record (MAR).

At this inspection we found the service to be in breach of Regulations 8, 12, 10, 11, 18 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of the report.