Quinnell House

Updated 18 February 2021

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 5 February 2021 and was announced.

Updated 18 February 2021

This inspection took place on the 14 and 17 May 2018 and was unannounced. At the previous inspection of this service in February 2017 the overall rating was requires improvement. At that inspection we found Breaches of Regulation 9, 11 and 17. This was because the provider had not ensured that people received person centred care and the risk of social isolation had not consistently been mitigated. The registered provider had failed to maintain accurate, complete and contemporaneous records and the principles of the Mental Capacity Act (MCA) 2005 had not been consistently applied in practice.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, responsive and well led to at least good. This inspection found improvements had been made and the breaches of regulation met but improvements were needed in well-led to ensure that quality assurance systems were further improved and embedded in to every day practices.

Quinnell 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. Quinnell House was registered to provide support to a maximum of 56 people who lived with dementia. The service does not provide nursing care on site and used district nurses to provide support when needed. 38 people were living at Quinnell House at the time of our inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

We undertook this unannounced comprehensive inspection to look at all aspects of the service and to check that the provider had followed their action plan as stated in their provider information return (PIR), and confirm that the service now met legal requirements. We found improvements had been made in the required areas. The overall rating for Quinnell House has been changed to good. We will review the overall rating of good at the next comprehensive inspection, where we will look at all aspects of the service to ensure the improvements have been sustained.

The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement. However, we found that audits were not consistently effective as they had not identified shortfalls in the management of diabetes and not all records to support the care delivered were consistently completed.

People told us they felt safe and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place. Staff had a good understanding of Equality, diversity and human rights. Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including the care of people with specific health disorders, such as diabetes. Formal personal development plans, including two monthly supervisions and annual appraisals were in place. Staff were supported to become ‘champions’ in areas of care delivery such as medicines and moving and handling. People were supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. The dining experience was pleasant and inductive to encouraging people to eat. People chose where to sit and it was a pleasant and social experience. One person said "The food here is excellent as good as a restaurant, fresh fruit, cakes and we can have anything at any time if we are hungry." Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's needs were met. The service worked well with allied health professionals

People felt well looked after and supported. We observed friendly and genuine relationships had developed between people and staff. People told us, “Staff are kind and lovely, nothing is too much trouble,” and “Very happy here, very caring.” Visitors told us, “Impressed with their kindness and knowledge,” and “I trust them and they have never let me down.” Care plans described people’s preferences and needs in relevant areas, including communication, and they were encouraged to be as independent as possible. People chose how to spend their day and staff were seen to support and guide people with kindness and empathy.

People were supported in a personalised way that reflected their individual needs. A range of activities were available for people to participate in if they wished and people enjoyed spending time with staff. Activities were provided throughout the day, seven days a week and were developed in line with people's preferences and interests. Further ideas for the prevention of social isolation for people who remained in their rooms were being discussed by the management team. Technology was used to keep families up to date if they lived away this was via protected internet access so they could discuss their loved ones’ care. There was a complaints policy and form available to people. Staff were open to any complaints and understood that responding to people’s concerns was a part of good care. People received a pain free and dignified death at the end of their lives. Staff supported people with compassion and worked with local hospice teams as required.

People and staff were positive about the culture of the service, staff and relatives felt the staff team were approachable and polite. The staff team worked in partnership with other organisations at a local and national level to make sure they were following current good practice. Maintenance records for equipment and the environment were up to date, such as fire safety equipment and hoists. Policies and procedures had been reviewed and updated and were available for staff to refer to as required. Staff said they were encouraged to suggest improvements to the service. Relatives told us they could visit at any time and they were always made to feel welcome and involved in the care provided.

Staff said the management team was fair and approachable, care meetings were held every morning to discuss people's changing needs and how staff would meet these. Staff meetings were held monthly and staff were able to contribute to the meetings and make suggestions. Relatives said the management was very good; the registered manager was always available and they would be happy to talk to them if they had any concerns.

The provider had sent CQC notifications in a timely manner. Notifications are changes, events or incidents that the service must inform us about.