Portelet Manor Rest Home

Portelet Manor Rest Home is a 'care home' registered to provide personal care to up to 28 older people. At the time of inspection, the home was supporting 23 people, including people with a learning disability and people with dementia.

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

There were inconsistencies in care plans therefore staff did not always have access to the most current information relating to people's care needs. Not all risks to people had been assessed. Quality assurance processes were not always effective. Whilst medicines were generally managed safely, audit checks of medicine administration records were not always completed in line with the provider's policy or best practice. The provider took action to address these shortfalls during inspection.

People were 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.

The registered manager demonstrated joint working with people and health and social care professionals, who provided support to meet people's health needs. The service involved people's families and advocates as appropriate.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Rating at last inspection

The last rating for this service was good (published 24 June 2019).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service had sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of fire safety, accidents and incidents. This inspection examined those risks.

You can see what action we have asked the provider to take at the end of this full report.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement and Recommendations

We have identified breaches in relation to consent, safe care and treatment and good governance at this inspection. We have made a recommendation about medicine management.

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, which will help inform when we next inspect.

Portelet Manor Rest Home was registered for 25 people. There were 18 older people living in the home at the time of our inspection. The home is an adapted building in a residential area of Bournemouth. People had a variety of care and support needs related to their physical and mental health.

This unannounced inspection took place on 10 November 2018. This was our first inspection of this service since it had been bought by the current provider in December 2017.

People and staff described that the home had been through a period of change. They were all confident that the new provider and the management team were ensuring improvements and stability.

People living in the home received care and support from staff who knew them well and understood their needs. People were happy with their care and they shared appreciation and confidence in the management and staff team. People were supported to make choices about their care. Staff understood how the MCA supported their work and that best interest decisions had been made when people could not consent to their care. Care plans reflected that care was being delivered within the framework of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had been applied for when necessary.

There were enough staff and this meant people had support, care and time, when they needed it, from staff who had been safely recruited.

There was not a registered manager for the service. 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. The registered manager had resigned and an application had been made to cancel their registration. The new manager had started their application to register with the CQC.

Staff understood people’s care needs and spoke about the individualised support people needed to meet these needs. They told us they felt well supported in their roles and had received training that provided them with the necessary knowledge and skills. There was a plan in place to ensure staff received refresher and specialised as deemed necessary by the provider.

Care documentation had been transferred to a computerised system and staff were positive about the benefits of this for accessing and monitoring information. This documentation was being reviewed and improved.

People felt safe. Staff understood the risks people faced and how to reduce these risks. Measures to reduce risk reflected the person’s preferences. Staff also knew how to identify and respond to abuse.

People told us they saw health care professionals when necessary and were supported to maintain their health by staff. People’s needs related to on going healthcare and health emergencies were met and recorded. People received their medicines as they were prescribed.

Where people had received end of life care in the home, we saw feedback from relatives that was consistent in its acknowledgement of the kindness and compassion of the staff team.

People described the food as good and there were systems in place to ensure people had enough to eat and drink.

People were engaged with activities that reflected their preferences, including individual and group activities both in the home and the local area. Staff had received training to develop the availability of meaningful activities.

Staff were cheerful and treated people and visitors with respect and kindness throughout our inspection.