Caer Gwent

Updated 22 June 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 one inspector.

Service and service type

Caer Gwent 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. Caer Gwent 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 from the provider, including statutory notifications. 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 six people and four relatives about their experience of the service. We spoke with the registered manager, the director of quality and care home operations, the deputy manager, a registered nurse, the housekeeping manager, the activities and wellbeing co-ordinator and two care staff.

We reviewed a range of records including five care plans and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 22 June 2022

About the service

Caer Gwent is a residential care home providing personal and nursing care to up to 61 older people with a range of health care needs, including some living with dementia. At the time of our inspection there were 54 people using the service. The home was purpose-built and care is provided within separate units of the home and over two floors, accessible by lifts and stairs. Communal areas include lounges, dining rooms, a library and gardens.

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

Some medicines used to treat two people’s eyes were being used beyond the time recommended by the manufacturer. These were immediately removed and replaced by the registered nurse on duty. Other aspects of medicines management were managed safely and people received their medicines as prescribed. People’s risks were identified and assessed, with guidance for staff on how to mitigate risks. Overall, the home provided a safe, physical environment.

Auditing systems were not sufficiently robust. The medicines audit had not recognised how medicines needed to be discarded to prevent the risk of them being used outside of safe timeframes. Recording of when one person’s fluids were required to be thickened was inaccurate which put the person at risk of choking if they received fluids that had not been thickened. Additional information for people at risk of falls had not been included when they received anti-coagulant medicines and were at higher risk of bleeding.

People’s dietary needs were met and people were positive in their comments. One person said, “The food is perfectly all right. I don’t expect home-cooking, but it’s good and it’s very edible”. Another person told us, “The food is very good. You get a good variety, with alternatives”. People had access to a range of healthcare professionals and services. The home was adapted to meet people’s needs. 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.

People were looked after by kind and caring staff who knew them well. People were complimentary of staff and the care they received.

Care was personalised and responsive to people’s needs. A range of activities was organised to provide mental stimulation for people. People were supported to stay in touch with families and friends, and social media was used to advantage. People could live out their lives at the home and their wishes were recorded and respected.

People and their relatives were asked for their feedback about the home and the care they received, and comments were positive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 February 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was undertaken to look at the actions taken by the provider since the last inspection in January 2020 and to see whether improvements had been made.

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. Please see the Safe and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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

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 monitor the service and will take further action if needed.

We have found breaches in relation to the disposal of medicines and audit, and accurate recording within people’s care records 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.