Background to this inspection
Updated
26 July 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by an inspector and an assistant inspector.
Service and service type
Rectory House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rectory House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 18 April 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
We spoke with nine people who used the service and two relatives about their experience of the care provided. We also spoke with seven members of staff including the registered manager, regional manager, a registered nurse and care workers. We reviewed a range of records. This included four people's care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We sought feedback from professionals who work with the service, for example, the local authority.
Updated
26 July 2022
About the service
Rectory House Nursing Home is a care home providing personal and nursing care to up to 48 people. The service provides support to older adults who have a range of physical health needs. At the time of our inspection there were 28 people using the service.
People’s experience of using this service and what we found
People told us they felt safe at Rectory House. However, we saw that staffing levels had been varied at times. We did not see any evidence of this negatively impacting on people but it limited the interactions staff had with people and was an area which required improvement.
Not all staff were observed to be wearing personal protective equipment (PPE) correctly. This was raised with the registered manager who took action while we were present. We have recommended that the manager review guidance and reiterate this to staff.
Staff demonstrated a good knowledge of how to keep people safe from abuse. Safeguarding concerns had been raised and investigated appropriately. Risks to people were assessed and clear guidance given to staff in how to minimise these. For example, people had equipment to minimise falls.
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.
There were systems in place to monitor the quality of care provided. People and their relatives told us they knew how to complain. Surveys were undertaken to gain feedback and drive improvement. Accident and incidents were monitored for patterns and trends, and learning opportunities taken when needed.
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 15 January 2020).
Why we inspected
This inspection was prompted by a review of the information we held about this service and concerns following a direct monitoring call. Concerns were around the use of PPE in the service, staffing levels and whether safeguarding concerns were being addressed and reported appropriately. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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.
We have found evidence that the provider needs to make improvements to their PPE practice. Please see the good section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rectory House Nursing Home on our website at www.cqc.org.uk.
Recommendations
We have made a recommendation about the use of PPE of staff and visitors.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.