Admiralty Care Home

Updated 9 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

This inspection was carried out by one inspector. An Expert by Experience made telephone calls to people’s relatives to gain their feedback. 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

Rogers House 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. Rogers House 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 a new manager was in post who had made an application to register with CQC. Their application was successful, and they were registered soon after the inspection. The new manager was present for the inspection and is referred to as ‘the manager’ though this report.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. 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 requested feedback from the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 6 relatives about their experience of the care provided. We observed the care provided within the communal areas. We spoke with 10 members of staff including the manager, the nominated individual, the interim deputy manager, senior care workers, care workers including agency staff, and domestic staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 5 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 9 August 2023

About the service

Rogers House is a residential care home providing personal care to up to a maximum of 43 people. The service provides support to people who have care needs, such as, diabetes, epilepsy, Parkinson’s disease. Some people were living with dementia or had deteriorating mobility. At the time of our inspection there were 23 people using the service.

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

Although improvements had been made to the identification and mitigation of individual risk and to the safe management of people’s medicines, further improvement was ongoing to ensure people’s safety.

Although there were improvements to how people were supported to make decisions and choices, people were still not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Although improvements had been made to the recording of peoples’ assessed needs, care plans were still a work in progress to capture people’s needs, and were not always reviewed and updated to reflect changes.

The provider’s governance systems were still a work in progress. Monitoring systems introduced since the last inspection were not always kept up to date to make sure people received safe and good quality care.

People were now kept safer by staff who knew their responsibilities to safeguard them and who felt more confident to raise concerns. Staffing levels had improved, and safer staff recruitment practices were now in place. The levels of agency staff had reduced and the agency staff supporting people now were regular agency staff who were treated as part of the team. The management of fire safety had improved, people’s evacuation plans were kept up to date and staff had completed fire evacuation drills.

Staff uptake of training updates had improved, and they felt better supported. People received better care with their health needs and the advice of healthcare staff was now followed. People were happy with the food provided and their meals and told us they could choose other options if they wished.

Staff said the culture had changed and they felt positive that there would be further improvements, Staff said they felt listened to and were more able to speak up if they needed to. Staff had only positive things to say about the manager and were happy with the changes being made. The provider had engaged with people, relatives and staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 16 December 2022) and there were breaches of regulation. We took urgent enforcement action against the provider. The provider also completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of some regulations, however improvements had been made.

This service has been in Special Measures since 8 September 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings 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.

We have found evidence that the provider needs to make further improvements. Please see the safe, effective and well-led sections of this full report.

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

Enforcement

We have identified breaches in relation to the assessment of risk and medicines management, mental capacity, record keeping and governance at this inspection.

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.