Archived: Queen Ann House

Queen Ann House is a residential care home providing personal care to people with a mental illness, some of who were also living with dementia. The service can support up to 22 people. At the time of the inspection the home was fully occupied.

Queen Ann House consisted of three houses that have been linked together to become one adapted building.

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

People told us they felt safe and happy living at Queen Ann House. Safeguarding processes were in place to protect people from abuse. Risks associated with people's health and support needs had been assessed and detailed guidance was in place for staff to follow.

During the inspection, we identified health and safety concerns which may have placed people at the risk of harm.

We have made a recommendation about the registered managers management and implementation of health and safety checks within the home.

There were quality monitoring systems and processes in place to identify how the service was performing and where improvements were required.

People were protected from the risks associated with the spread of infection. The service was clean.

There were enough numbers of staff available to meet people's needs and ensure their safety. Appropriate recruitment procedures ensured prospective staff were assessed as suitable to work in the home.

Medicines were managed and administered safely. However, guidance was not always available where medicines had been prescribed on an ‘as and when required’ basis. This was addressed promptly following the inspection.

Staff received appropriate induction, training and support and applied learning effectively in line with best practice. This meant people’s needs were safely and effectively met ensuring a good quality of life.

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.

Staff were caring and kind and relatives confirmed this. We observed staff responding to people's needs with kindness and respect.

Care plans in place detailed people’s needs and preferences. People’s care needs were assessed prior to admission and reviewed thereafter.

Staff supported people to meet their health and nutritional needs. Staff worked with health care professionals to maintain people's wellbeing.

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 29 May 2018).

Why we inspected

This was a planned inspection based on the previous rating.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

During the inspection we identified concerns with certain areas of health and safety at the home and the monitoring and management oversight processes of these. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Queen Ann House on our website at www.cqc.org.uk.

The overall rating for the service has remained as good.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the time of this inspection there were 18 people living at the service. In an adjoining house seven people lived in a supported living environment. The provider did not provide personal care to these people and so this service is not regulated by the Care Quality Commission.

At our last inspection on 20 and 21 June 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

This inspection took place over two days (on 21 February and 6 March 2018) and was unannounced. We brought this comprehensive inspection forward as there had been two safeguarding concerns reported to CQC. These were being investigated by the local authority at the time of the inspection.

The majority of people said they were happy in the home and felt safe and well supported. Staff demonstrated a good level of understanding of safeguarding and were able to explain procedures to respond to allegations of abuse.

Care plans contained risk assessments which gave guidance to staff on how to support people by minimising any risks to their safety or wellbeing. Staff ensured that people were involved in making decisions about their care and support. Care plans were reviewed monthly or as people’s needs changed.

There were enough staff employed to safely meet the needs of people living at the service. Staff recruitment had not been consistently robust which put people at risk. We highlighted the issue we found to the registered manager who addressed the issue and we have made a recommendation about safe recruitment practices. Staff received training and supervision and felt supported by the management team.

The service had good systems and processes in place to ensure the safe management of people’s medicines.

People received enough to eat and drink to meet their individual needs and timely action was taken by staff when they were concerned about people's health. Staff made referrals to healthcare professionals to ensure people's health was maintained and the service had a wellbeing coordinator who took overall responsibility in supporting people with medical appointments.

People and relatives were generally positive about the service and the staff who supported them. Most people told us they liked the staff and were treated with dignity and kindness.

The service was clean to an adequate standard. The registered manager was making improvements to the environment such as setting up a “wet room” which was suitable for people who had difficulties with standard showers.

A complaints procedure was in place and people and their relatives said they felt comfortable raising concerns and that their views would be listened to and acted on.

People, relatives and staff spoke positively of the management team. Quality assurance processes were in place to monitor the quality of care delivered.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Where people's liberty was deprived, the registered manager had applied for authorisation from the appropriate authority.

The provider had processes in place to ensure that the quality of care was regularly monitored and checked and we found that learning took place and continuous improvements were made.

The provider did not notify us of a notifiable incident as required. They made the notification after the inspection when we raised this as a concern.

Further information is in the detailed findings below.

Queen Ann House is a care home that provides accommodation and care to a maximum of 22 people who have mental health issues. On the day of the inspection there were 19 people residing 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 about how the service is run.

People told us they felt safe at the home and safe with the staff who supported them. They told us that staff were kind and respectful and they were satisfied with the numbers of staff on duty at the home.

The registered manager and staff at the home had identified and highlighted potential risks to people’s safety and had thought about and recorded how these risks should be reduced.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and told us they would presume a person could make their own decisions about their care and treatment in the first instance. Staff told us it was not right to make choices for people when they could make choices for themselves.

People had good access to healthcare professionals such as doctors, dentists, chiropodists and opticians and any changes to people’s needs were responded to appropriately and quickly.

People told us staff listened to them and respected their choices and decisions.

People using the service, their relatives and staff were positive about the registered manager and his management of the home. They confirmed that they were asked about the quality of the service and had made comments about this. People told us the registered manager took their views into account in order to improve service delivery.