Archived: Partridge Care Centre

Updated 22 June 2016

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 made the necessary improvements and was meeting the legal requirements and regulations associated with the Health and Social Care Act 2012.

The inspection was carried out on the 5 May 2016 and was unannounced. The inspection team consisted of three inspectors, a nurse specialist advisor and an expert by experience. The specialist advisor had the experience in nursing and healthcare, elderly care and within the field of palliative care. The expert by experience is a person who has personal experience of having used a similar service or who has cared for someone who has used this type of care service.

Before the inspection we reviewed information we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us.

We carried out observations in communal lounges and dining rooms and used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us due to their complex health needs.

During the inspection we spoke with eight people who lived at the home, eight relatives, nine care staff some of whom were agency staff, four nurses, one team leader, the manager and a newly employed quality assurance consultant. We looked at care records relating to 10 people and other records relating to the management of the home. We reviewed information we received from the provider following the inspection visit.

We also received feedback from the local authority and commissioners prior the inspection.

Updated 22 June 2016

The inspection took place on the 5 May 2016 and was unannounced. Partridge Care Centre is a purpose built home set over three floors. It provides personal and nursing care for up to 117 older people, some of whom live with dementia. At the time of our inspection 65 people were using the service. Following our inspection of the service on 23 July 2015 we imposed a condition on the provider’s registration to prevent them from admitting any further people to Partridge Care Centre because of the concerns that we found. This condition remains in place.

At the time of our inspection there was a manager who had been in post for nine weeks but they had not registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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. However, following our inspection we were informed that the manager had left the service.

When we last inspected the service on 14 and 15 January 2016 we found the provider was not meeting the required standards. We found breaches of the Regulations in relation to safe care and treatment, staffing, safeguarding people, consent, privacy and dignity, person-centred care, meeting nutritional and hydration needs, receiving and acting on complaints and good governance. At this inspection we found that some improvements had been made although systems to sustain improvements were still under development.

People told us they received care from staff which was safe and met their needs. The provider was using a high number of agency staff to cover for staff vacancies and planned and unforeseen absences. When we last inspected the service the high use of agency staff was poorly managed and put people at risk of harm due to the lack of information given to agency staff. We found that this had improved and agency staff working at the service were regular, pre-booked for a longer period of time to help ensure people had consistency in the care they received.

People were assisted by care staff who had been trained and had their competency assessed to help ensure the care provided to people was safe and met their needs. We found that staff followed recommendations from social and health care professionals involved in people`s care. However, we found that not all the nursing staff working at the service had the necessary skills and knowledge required to meet the needs of the people living at the home.

When we last inspected the service in January 2016 we found that people’s freedom of movement had been restricted and restrained in ways that did not comply with nationally recognised good practice or the deprivation of liberty safeguards (DoLS). At this inspection we found that the manager has stopped these practices and where people required restrictions to their freedom, this had been done following the right processes.

Accidents and incidents were monitored and reported to the local safeguarding team and CQC where necessary and appropriate. We found that the internal systems to identify trends and patterns had improved and the manager and a consultant were working to develop the system further to ensure information and learning points were shared with staff to prevent accidents and incidents from reoccurring.

We found that both permanent and agency staff`s knowledge about safeguarding people from harm or any possible abuse had improved since the last inspection. Staff were able to tell us the process of reporting any concerns both internally and externally. Information about safeguarding and contact details for the manager and external safeguarding authorities were prominently displayed around the home.

Safe and effective recruitment practices were followed to check that staff were of good character, physically and mentally fit for the role and able to meet people’s needs. However, there was still a high turnover of staff as the provider was not able to recruit and retain a permanent staff group.

We found that people had their medicines administered by nurses who were trained and had their competencies monitored by the manager. There were regular audits carried out in relation to medicines. However we found that records for administered medicines had not always been signed by the staff responsible. One person had missed two doses of their medicine, although this had been available staff had recorded that it was out of stock.

Records were reflective of people`s needs and were regularly reviewed by staff. We saw that improvements had been made to care records in relation to person centred information about people`s likes and dislikes. The manager, deputy manager and clinical lead had held meetings with relatives and people who used the service and involved them in reviewing their plan of care.

People had mixed views about the quality of the food provided. Although it was in sufficient quantities people told us that the choices and alternatives offered if they were not happy with the main meal on offer were not appropriate for main meal choices, like sausage rolls.

All the people we talked with and their relatives were highly complementary about the new manager. Everybody knew the manager by name although they had only been in the service since March 2016. People told us they had faith that anything they asked for or reported to them was taken seriously and resolved.

Staff told us they were well supported by the new manager and they appreciated how approachable and open they were. Staff told us the new manager had put systems in place to improve the service people received and that they were consistent in imposing high standards of care.