Catherine Court

Updated 22 April 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

The inspection was carried out by two inspectors and a pharmacist. Two Experts by Experience supported the inspection by making calls to people who used the service and their family members after the inspection.

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

Catherine Court 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. However, the registered manager had resigned prior to the inspection. An operations support manager was managing the service as an interim manager and they planned to become registered with the Commission until a suitable replacement manager had been appointed.

Notice of inspection

This inspection was announced by phone on arrival, before the inspectors entered the service.

What we did before the inspection

We reviewed information we had received about the service since the last 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 the interim manager, deputy manager, a registered nurse, two care staff, housekeeping staff member, laundry staff member, governance manager, regional director, provider clinical support manager and provider clinical governance lead.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records which included three care plans, daily observation records for three other people, accident report, infection control, maintenance and ten medicine administration records.

After the inspection

We spoke with four people who used the service and three relatives. We set up telephone interviews with the service and spoke with a registered nurse, a team leader, three care staff and a housekeeping staff member. We sought feedback from professionals involved with the service. We reviewed a variety of records relating to the management of the service, including policies, procedures, audits and complaints. We reviewed six care plans and five staff files remotely and continued to seek clarification from the provider to validate evidence found.

Updated 22 April 2021

About the service

Catherine Court is a nursing home providing personal and nursing care to 35 people aged 65 and over at the time of the inspection. The service can support up to 60 people.

Catherine Court accommodates people across two floors with each floor having their own communal sitting, dining and small kitchen areas. People’s bedrooms have en-suite facilities and each floor has a communal larger shower.

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

People told us they were happy with their care. They commented “I am happy here; it feels like home to me. The girls are wonderful, friendly, lovely people.” and “I am happy, they treat you natural, it is brilliant, the staff are very kind.”

Relatives found it difficult to comment on the care provided due to the restrictions on visiting imposed over the year, due to the Covid-19 pandemic. However, they felt their family member received safe care and they were generally happy with the care provided. They commented “Staff are fantastic, brilliant and doing a very difficult job. The home has had three outbreaks of the virus and everyone has recovered...that must say something of their skills.”

Relatives believed there had been a high turnover of staff at the service and this impacted on continuity of care. A relative commented “Last year when Covid-19 struck staff left and the home had to replace them...turn over has been very high as it’s a difficult job. Agency staff have been used a great deal, both during the day and night, so very little continuity.’

Whilst relatives had received some communication from the provider and the service during the pandemic, they felt communication with the service had been poor. They confirmed the interim manager had recently held a zoom meeting with relatives to update them on changes within the service, including arrangements for visiting.

We received mixed feedback on the quality of food and activities provided. This was shared with the provider to follow up and address.

We found risks to people were identified but not always managed and some practices around infection control needed to improve to mitigate the risks of cross infection.

Aspects of the service were audited and had picked up some of the issues we identified. Other issues in relation to working to infection control guidance had not been picked up and some records relating to people’s care and the running of the service were not suitably maintained and accurate.

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; however, people’s records did not always support this practice

Systems were in place to safeguard people from abuse. However, processes needed to improve to promote learning from accidents, incidents, safeguarding and complaints to ensure trends were picked up and addressed to safeguard people and prevent reoccurrence.

Safe medicine practices were promoted, and sufficient staff were provided to meet people’s needs. Staff were safely recruited, and systems were in place to ensure staff were suitably inducted and trained for their roles. The interim manager was reviewing staff inductions, training and supervisions to ensure gaps in knowledge were addressed and staff were supported.

The registered manager had recently left, and an interim manager was managing the service. until a new manager was appointed. The interim manager was committed to improving the service, communication, developing staff and supporting the team in their roles to provide positive outcomes for people. Staff were complimentary of the interim manager and told us he was accessible, approachable, encouraging and supportive. They felt listened to and felt issues raised would be addressed.

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 22 November 2018)

Why we inspected

The inspection was prompted in part due to trends in notifications around poor moving and handling practices, increase in safeguardings and concerns about the service, which included concerns around people’s nutritional needs not being met. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. 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.

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

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.