About the service Polonia Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service can support up to nine people aged 65 and over and mainly from eastern European backgrounds living with dementia. On the day of the inspection eight people were living at the service.
People’s experience of using this service and what we found
The provider had better oversight of the home’s maintenance and safety checks were in place for gas, fire, water and electrical safety. Fire safety arrangements were in place; however, the home’s fire risk assessment had not been completed by a competent person in this area. Assurances were provided a new fire risk assessment would be undertaken by a competent assessor.
Procedures to support the safe recruitment of staff had improved and there were enough staff on duty to provide the support people needed. People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns.
New flooring in the home replaced the previous patterned carpets, however the home required further modernisation to create a dementia friendly environment for people using the service.
The home was clean, and all staff completed training in infection prevention and control. There were clear measures in place to manage the risk of the COVID-19 pandemic. However, we signposted the registered manager to guidance to ensure the home’s infection control policy and procedures included the Coronavirus pandemic.
Staff received support via supervisions and training the provider considered mandatory. However, the provider’s induction process for new staff needed to be revamped to ensure the Care Certificate (an accredited course) or its equivalent was introduced.
During the inspection we identified outstanding notifications of events which should have been sent to CQC, when they had occurred. This demonstrated a lack of effective oversight and systems within the service.
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 supported
this practice. However, the provider’s oversight of people’s Deprivation of Liberty Safeguards (DoLS) needed to be improved, records on the day of inspection were not available.
People living at the home were happy and supported well by caring staff. People received care and support personalised to their individual needs and suited to their communication preferences.
Risk assessments and care plans were thorough and up to date and provided staff with enough detail to support people safely. Plans had also been translated in people’s preferred language.
Improvements of the homes risk management procedures were found following our last inspection. However, the service needed to implement new quality systems to ensure there was a better oversight of performance and quality at provider level. Despite our findings, people we spoke with were happy with the care provided and staff felt supported by the registered manager.
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 requires improvement (published 28 May 2019). At the last inspection we issued the provider with a warning notices for Regulation 15, 17 and 19. At this inspection we found persistent issues connected to the home’s governance systems and the home remained in breach of regulation 17.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and establish if they were meeting the legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained 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.
Enforcement
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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.