The Place Up Hanley

The Place Up Hanley is a care home providing personal care. The home is registered to support up to 51 people. At the time of the inspection there were 30 people living there. The home supported younger and older people, some of the people were living with dementia or other mental health support needs. Some people may also have had physical or sensory disabilities.

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

New quality assurance systems were being introduced however we could not be sure these would always be effective and as they were not yet embedded. The registered manager was honest that the systems were a work in progress. Medicines processes had improved, but some improvements were still needed. Some care plans did not contain enough detail, particularly after incidents had occurred. Some people needed extra support due to their needs and it would be beneficial if more in depth training was offered to staff. Two people did not have the necessary assessments in place regarding their decision-specific capacity, however other people did have this in place. The registered manager was open to feedback and acted on omissions we identified.

People were protected from the risk of infection and were supported to have visitors in line with government guidance. We observed enough staff to support people, although there was some mixed feedback about this. Staff were recruited safely. People were protected from abuse; staff understood their responsibilities and referrals had been made when necessary. Staff received training to be effective in their role and they felt confident. There was mixed feedback about food, however people had sufficient amounts to eat and drink and had a choice. People had access to other health professionals. The home was clean and adapted to meet the needs of those living there.

The provider was receiving support from an external consultant to help the service improve. The registered manager was aware of their duty of candour, although there was some mixed feedback about communication within the service from relatives. Relatives and staff were positive about the registered manager, they felt the service had improved and staff felt more supported. People were supported with their individual needs. The registered manager worked in partnership with other organisations and had responded to local authority feedback in order to make improvements.

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 requires improvement (published 12 April 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

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 these were inspected at to calculate the overall rating. The overall rating for the service has remained requires improvement, however there are no longer any breaches of regulations.

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

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. We will work alongside the provider and local authority to monitor progress.

The Place Up Hanley is a care home providing personal care. The home is registered to support up to 51 people. At the time of the inspection there were 36 people living there. The home supported younger and older people, some of the people were living with dementia or other mental health support needs. Some people may also have had physical or sensory disabilities.

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

Governance systems in place had failed to fully identify improvements needed so we could not be sure all concerns would be addressed. Medicines were not always managed safely. Risks to people’s health and wellbeing were not always assessed and planned for in a timely manner. People were protected from cross infection risk, however we noted improvements were needed to staff risk assessments, policies being updated and staff practicing good hand hygiene after touching their masks. Lessons had not always been learned when things went wrong as the service remained rated as requires improvement. People did not have their decision specific capacity assessed. People were not supported to have maximum choice and control of their lives; the policies and systems in the service did not support this practice.

Some staff training had not been completed but plans were in place to bring this up to date. The physical environment needed improvement, but plans were in place to complete this, which we saw evidence of during our inspection. People were supported to access other health professionals, but their care plans were not always updated in a timely manner.

The manager was aware of their responsibility in relation to duty of candour. Notifications were submitted as necessary and the previous inspection rating was being displayed appropriately. Relatives and staff found the manager approachable and could raise concerns. The provider worked in partnership with other organisations.

There was a sufficient number of safely recruited staff. People were protected from the risk of abuse by staff who understood their safeguarding responsibilities and appropriate referrals were made. People had enough food and drinks in line with their needs.

Rating at last inspection and update

The last rating for this service was requires improvement overall (published 23 July 2019). The service has remained rated as requires improvement overall.

Why we inspected

The inspection was prompted in part due to concerns received about incidents that had occurred in the service. A decision was made for us to inspect and examine the response to those incidents. We also followed up on the previous breaches of regulation. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 previous comprehensive inspections 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 coronavirus and other infection outbreaks effectively. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

Enforcement

We have identified multiple breaches of regulation in relation to the safe care and treatment of people, checking consent and the governance arrangements in the home.

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.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

The Place Up Hanley is a residential care home providing personal care to 34 people at the time of the inspection. The service can support up to 51 people with different health and care needs, including dementia, across one single-floor adapted building.

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

At the last inspection we rated the service as good. At this inspection we found improvements were needed across the service and the provider was aware of this. We found breaches of regulation with regards to good governance and ensuring well-supported, competent staffing of the service.

There were record-keeping and person-centred planning issues across the service. The provider was open and honest about their awareness of these issues and their plans to address them. Quality checks had been completed and identified issues but had not always led to improvements. Information in care records was not always complete, consistent and well-organised to support safe and effective person-centred care. Staff did not always feel well supported and listened to. There were significant improvement needs to training and supervision. The service had gone through several changes in management and this had in parts created an unsettled culture. This was clear from some of our conversations with staff.

When we spoke with people using the service, relatives and professionals, we heard that overall people’s experience of the service was positive. However, people and staff felt there were not always enough staff to meet people’s needs promptly. Staff felt that while they were able to complete care tasks and keep people safe, they did not always have time to spend with people and listen to them. We made a recommendation regarding the planning of staff deployment. We observed that the hands-on care people received was person-centred and caring. There was a generally calm, relaxed atmosphere when we visited.

More regular meetings took place for people using the service, relatives and staff. We received feedback about communication issues and discussed these with the provider. We found that the service had improved activities that were on offer and these helped to positively engage and stimulate people. People also enjoyed the inclusion of community volunteers. The service connected well with other professionals and the wider community. The provider was working closely with the local authority to achieve improvements and we saw examples of planned developments. There had only been one recorded complaint in 2019. People told us that if they had issues or grievances, these were always listened to and addressed.

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; the policies and systems in the service generally supported this practice. We pointed out some record-keeping issues and development needs that the provider was already addressing.

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 7 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches at this inspection in relation to record-keeping and the effective monitoring of people’s safety and care, as well as sufficient support to ensure good staffing.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 and associated Regulations about how the service is run.

We found that the Mental Capacity Act 2005 was not being followed consistently throughout the service and that some mental capacity assessments had not been carried out where these may have been needed. Staff were trained in most areas of delivering safe care, however, there were gaps in relation to dementia care and challenging behaviour.

Complaints had been recorded and action taken as a result but we did find that these had not always been adequately responded to. This was addressed during the course of our inspection.

People felt safe at the service and risks associated with their care delivery had been assessed and planned for. Staff were trained in safeguarding and knew how to protect vulnerable people from abuse. People's medicines were safely managed and there were enough staff working at the service to meet people's needs. We found that staff had been safely recruited.

People could choose how they spent their time and were offered a choice of nutritious food and drink. There were activities available for people and people were able to maintain links with the local community wherever possible.

Staff were kind and caring and people were given the opportunity to be involved in their care.

The service was managed well. Staff felt supported and there was a positive atmosphere and supportive culture within the service.

The manager notified the relevant agencies when incidents occurred at the service and accidents and incidents were logged and action taken to reduce the risk of them re-occurring.