We carried out a review of the data available to us about Canwick House Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Canwick House Care Home, you can give feedback on this service.
We found the following examples of good practice.
• There was a visiting pod in the garden which could be accessed without visitors entering the home. The pod had a glass screen to separate visitors and residents and was heated and had ramped access. This meant that visits to residents were supported in a way that ensured visitors to the home would not spread infection to residents or staff.
• Staff wore appropriate PPE correctly and had made a video for visitors about how to wear PPE, which had subtitles in different languages.
• Staff took additional measures to reduce the risk of infection such as using removable chair covers which were washed daily, social distancing of residents in communal spaces and cleaning of regular touch points with antimicrobial products.
• Managers had adapted ways of delivering meetings, handovers and training to reduce unnecessary staff contact.
Canwick House 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. It provides accommodation for a maximum of 20 older people in a single house. At the time of our inspection there were 14 people living at the service.
People’s experience of using this service and what we found
There was a process in place to carry out quality checks. These were carried out on a regular basis. The home was clean, and staff understood how to prevent and manage infections.
There was enough staff to support people. Appropriate employment checks had been carried out to ensure staff were suitable to work with vulnerable people. Arrangements were in place to safeguard people against harm and staff were aware of these. People said they felt safe.
People enjoyed the meals and their dietary needs were catered for. This information was detailed in people’s care plans. Staff followed guidance provided to manage people's nutrition and pressure care. People were supported by staff who had received training to ensure their needs could be met. Staff received regular supervision to support their role.
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 had good health care support from external professionals. When people were unwell, staff had raised the concern and acted with health professionals to address their health care needs. People had access to a wide range of activities and leisure pursuits and were involved in planning these.
We saw evidence of caring relationships between staff and people who lived at the home. Staff were aware of people's life history and preferences and used this information to develop relationships. People felt well cared for by staff. Care records were personalised and were regularly reviewed. People had been involved in the development and review of their care plan.
The provider had displayed the latest CQC rating at the home and on their website. When required notifications had been completed to inform us of events and incidents.
More information is in the detailed findings below.
Rating at last inspection
The last rating for this service was Requires Improvement (published 16 March 2018). At this inspection the service had improved to Good.
Why we inspected
This was a planned inspection based on the previous rating however the inspection was prompted in part due to concerns received about the management of the service. A decision was made for us to inspect. However, we did not examine those risks on inspection and are following up on our concerns outside of this regulatory process. We found no evidence during this inspection that people were at risk of harm from this concern. However we are continuing to monitor the issues with the provider.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
As a single provider the location did not require a registered manager. The provider was registered as 'registered person' to oversee and manage care. 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.
The service had previously been rated as ‘requires improvement’. At this inspection the service was rated overall as ‘requires improvement’. The service had addressed the issues raised at previous inspections and arrangements were in place to deliver a good standard of care and improve quality. However, the service has been rated as 'requires improvement' in 'well led' with repeated breaches of regulation, a breach of Health and Social Care Act (Regulated Activities) regulations 2014 regulation 17 was found. In addition a breach of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 18 was identified. The service has not fully met some of the regulations since September 2016. We are in the process of considering further action with regard to the provider not meeting regulation. We have taken this into account when considering our rating in this domain.
There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. The environment was clean. There were arrangements to prevent and control infections.
Guidance and systems were in place to ensure people received their medicines when required and processes were in place to manage medicines. Where people were unable to make decisions arrangements were in place to ensure decisions were made in people's best interests. Best interests decisions were specific to the decisions which were needed to be made.
A system was in place to carry out suitable quality checks and appropriate checks had been regularly carried out and where identified actions had been taken to improve the service. The registered person had ensured that there was enough staff on duty. In addition, people told us that they received person-centred care. Sufficient background checks had been completed before new staff had been appointed according to the provider’s policy.
Staff had been supported to deliver care in line with current best practice guidance. Arrangements were in place to ensure staff received training to provide care appropriately and effectively. People were helped to eat and drink enough to maintain a balanced diet. People had access to healthcare services so that they received on-going healthcare support.
People were supported to have choice and control of their lives. Staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.
People were treated with kindness, respect and compassion and they were given emotional support when needed. They had also been supported to express their views and be involved in making decisions about their care as far as possible. People had access to lay advocates if necessary. Confidential information was kept private.
Information was provided to people in an accessible manner. People had been supported to access a range of activities. People were supported to access local community facilities. The registered person recognised the importance of promoting equality and diversity. People’s concerns and complaints were listened and responded to improve the quality of care. Arrangements were in place to support people at the end of their life.
The registered person promoted a positive culture in the service that was focused upon achieving good outcomes for people. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. People, their relatives and members of staff had been regularly consulted about making improvements in the service. There were arrangements for working in partnership with other agencies to support the development of joined-up care.
Further information is in the detailed findings below.
Canwick House provides care for older people including people who are living with dementia. It provides accommodation for up to 20 people who require personal and nursing care. At the time of our inspection there were 16 people living at the home.
There was not 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.
On the day of our inspection staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe.
Medicines were administered to people safely however the provider did not have systems in place to ensure the safe management of medicines.
We saw that staff obtained people’s consent before providing care to them. Where people could not consent, assessments to ensure decisions were made in people’s best interest had not been consistently completed. This issue had been identified at our previous inspection and the provider had failed to fully address the issue. There was a breach of Regulation 11. You can see what action we told the provider to take at the back of the full version of the report.
We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.
There was sufficient staff available to meet people’s needs. Staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support. People were treated with respect.
Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place. Staff had received supervision and appraisals. People were provided access to social activities. They were supported to maintain relationships that were important to them.
Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Audits were carried out and action plans put in place to address any issues which were identified. However the provider had failed to identify the issues we found at this inspection. Accidents and incidents were recorded and investigated. The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Canwick House Care Home on our website at www.cqc.org.uk.
This inspection took place on 7 February 2017 and was unannounced. Canwick House provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 22 people who require personal and nursing care. At the time of our inspection there were 18 people living at the home.
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. However on the day of our inspection they were unavailable and the provider was unable to tell us when they would be available.
At this inspection we found that the provider had failed to ensure that previous improvements had been sustained. We found that there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of this report.
The provider did not always act in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.
Records were not accurate. Care plans were not updated consistently and did not reflect the care people required. Five people who were at the home for a short period of time did not have care plans or completed assessments.
Medicine records were inaccurate and not completed consistently.
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.
On the day of our inspection staff interacted well with people and people were cared for safely. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe. Medicines were usually administered safely. Medication administration sheets (MARS) were completed fully. Allergies were not recorded consistently on the identification sheets in the medicine records.
The provider did not consistently act in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.
We found that people’s health care needs were assessed and care delivered to meet those needs. Care records did not always reflect the care people required. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported to eat enough to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.
There were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered. Staff had a good understanding of people’s needs and were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision.
People were provided with access to a limited range of activities.
Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Audits were carried out and action plans put in place to address any issues which were identified, however some issues had not been identified by the audit process. Accidents and incidents were recorded. The provider had informed us of incidents as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.