Background to this inspection
Updated
14 May 2020
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.
Inspection team
The inspection was carried out by two inspectors and a specialist nurse advisor.
Service and service type
Churchfield Care Centre 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we held about the service such as notifications. These are events which happened in the service that the provider is required to tell us about. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the local authority that monitors the care and support people receive and Healthwatch Nottinghamshire. 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 three people living there and eight relatives. We spoke with the manager, the regional director, a registered nurse and 11 members of the staff team. We also spoke with three visiting healthcare professionals. We observed support being provided in the communal areas of the service. We reviewed a range of records about people's care and how the service was managed. This included six people's care records and associated documents including risk assessments and a sample of medicine records. We looked at records of meetings, staff training records and the recruitment checks carried out for three new staff members employed since our last visit. We also looked at a sample of the provider's quality assurance audits the management team had completed.
After the inspection
The manager provided us with further evidence to demonstrate compliance with the regulations.
Updated
14 May 2020
About the service
Churchfield Care Centre is a care home providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service is registered to support up to 60 people.
People’s experience of using this service and what we found
The provider did not have effective systems and processes in place that enabled them to identify, monitor and assess risks to the health, safety and welfare of the people using the service. The provider had persistently failed to act where improvements had been required.
Risks to people had not always been identified and actions identified to mitigate risks had not always been followed. The management of people’s medicines was not robust, and the providers recruitment process had not always been followed. Staff did not always protect people from avoidable harm because safe moving and handling practices had not been followed. Staff had not always followed best practice, around infection control prevention.
People’s needs had been assessed prior to them moving into the service, though plans of care were not always accurate or up to date. Planning for people’s end of life had not always been thoroughly explored. Capacity assessments and best interest decisions were included in people’s plans of care though, shortfalls within the Deprivation of Liberty Safeguarding process were identified.
Staff were overall provided with the training they needed in a timely manner. People were supported to eat and drink enough to maintain a balanced diet and staff knew people’s preferences. The staff team supported people to access relevant healthcare professionals when they needed it.
People told us the staff were kind and caring and we observed them treating people with respect. Staff supported people to make decisions about their care whenever possible and their consent to their care was obtained. People knew how to make a complaint if they were unhappy about anything.
The staff team felt supported by the manager and their thoughts on the service were sought. The manager had reintroduced meetings providing people using the service and their relatives with the opportunity to share their thoughts on the service. The staff team worked in partnership with others to provide people with the care and support they needed.
The new manager was committed to making improvements to the service moving forward and had already identified and addressed several shortfalls found.
Rating at last inspection: The last rating for this service was requires improvement (published 9 January 2019). The service remains rated requires improvement. This is the fifth consecutive time this service has been rated requires improvement.
Why we inspected:
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvement. Please see the safe, effective, responsive 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 Churchfield Care Centre on our website at www.cqc.org.uk.
Enforcement
We have identified a breach in relation to the systems and processes used to assess, monitor and improve the service.
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.
Update 11 May 2020 - We are mindful of the impact of 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 monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so. A serious concerns letter will be issued as a result.
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.