Archived: Shiels Court Care Home

Updated 12 December 2020

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 (IPC) 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 10 November 2020 and was unannounced.

Updated 12 December 2020

Shiels Court 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.

The care home accommodates up to 40 people in one adapted building. At the time of this inspection there were 37 people living in the service. The service provides accommodation and personal care to people living with dementia and mental ill-health.

There was a registered manager in post. 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.

When we completed our previous inspection on 13 and 14 February 2018 we found concerns relating to the deployment of staff throughout the home. We also found that staff were unclear when and how to apply the Mental Capacity Act (MCA) 2005.

At this inspection we found ongoing concerns relating to staffing, training and the application of the MCA. People using the service had been diagnosed with dementia or mental ill-health and most were unable to make safe choices relating to their wellbeing. Care plans did not show how decisions had been reached to ensure they were kept safe. Staff continued to show limited understanding of the relevant procedures and legislation. Some staff had still not received training to ensure they had the right skills and knowledge to meet the needs of people using the service.

We identified concerns around the management of people’s safety. Risk assessments relating to people’s care needs lacked detail and were not routinely updated. Measures identified to reduce certain risks in the home, such as exposed hot pipes, had not been put in place. Staff recruitment and safeguarding reporting was not consistently robust. Medicines were administered safely but medicine records were not always accurate. Staffing levels did not enable appropriate levels of support at meal times.

The provider had failed to respond to an action plan arising from the previous CQC inspection. This demonstrated shortfalls in the leadership of the service. The service’s governance systems required improvement to manage risks and drive improvement. Management did not routinely seek feedback on the service.

Staff did not always have time for meaningful interactions with people. For example, at lunchtime some people did not receive encouragement and support to ensure they ate their food. Care plans were not always up to date and did not contain information about people’s end of life care preferences.

Staff sought people’s consent before undertaking tasks and they offered people choice with their care. Staff also supported people to be independent where possible. Staff worked well with other healthcare professionals to ensure people’s health care needs were met. Referrals to specialist health care agencies were made promptly, as required. People and relatives reported that staff were kind and caring and they delivered care which responded to people’s needs and wishes.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This is the third time the service has been rated Requires Improvement.