Continuing Care Services t/a The Promenade

Updated 27 April 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 included checking the provider was meeting COVID-19 vaccination requirements. 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

Two inspectors carried out this inspection.

Service and service type

Continuing Care Services t/a The Promenade 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. Continuing Care Services t/a The Promenade is a ‘care home’ is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was announced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. 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 all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, the deputy manager, and three care workers. We reviewed a range of records. This included three people's care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

After the inspection we continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 27 April 2022

About the service

Continuing Care Services t/a The Promenade is a ‘care home’ providing accommodation and personal care to up to 24 people. The service provides support to older people and people who may be living with dementia. At the time of our inspection there were 17 people using the service.

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

The service was not always well-led. Systems were not always effective to assess, monitor and improve the quality and safety of the service. The lack of systems meant the provider had failed to identify and address the concerns we found at this inspection. Processes to gather feedback from people and key stakeholders to improve the quality of the service had not been carried out. Best practice was not always embedded into the service.

The service was not always safe. Risks in relation to the spread of infection and COVID-19 were not effectively managed. Government guidelines in relation to wearing and disposing of PPE was not always followed. Fire safety measures were not robust and risks to people were not always managed.

There was lack of time for staff to engage with people during the inspection. There was no tool used to assess the staffing levels to ensure they were appropriate and in line with people’s needs. We have made a recommendation about this. Recruitment checks when staff started employment and ongoing checks to ensure staff remain of good character were not always in place or were not robust.

Best practice guidance was not always followed when administering medicines. Protocols were in place when people were prescribed ‘as and when required’ medication, but further detail was required.

Relatives were positive about the service and the kind caring nature of staff. Staff told us they felt supported by the management team. The registered manager was open and honest throughout the inspection.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 16 April 2018)

Why we inspected

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. This included checking the provider was meeting COVID-19 vaccination requirements.

We undertook a targeted inspection to follow up on infection control practices within the service. The inspection was prompted in part due to an outbreak of COVID-19. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with infection control and risk management in relation to COVID-19, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Continuing Care Services t/a The Promenade on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to governance, risk management and infection prevention and control at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.