Archived: Carders Court Care Home

At the last inspection of June 2017 there was a breach in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations. Regulation 12 Safe care and treatment. This was for some aspects of medicines management which was not safe. The service sent us an action plan to show us how they would improve. At this inspection the service had improved and there were no breaches.

There was no registered manager. However, there was a person employed by the service experienced in care home management who had applied to become registered manager. The application is currently being processed by the CQC. A registered manager is a person who has registered with the Care Quality Commission (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.

We made a recommendation in relation to medicines. We asked the provider to look at best practice guidance around the returning of medicines no longer required.

We made a further recommendation in relation to signage in the environment. We asked the provider to look at best practice guidance around the signage of all units of the home where people have a dementia related illness.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

Recruitment procedures were robust and ensured new staff were safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

The home was clean, tidy and homely in character.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business contingency plan for any unforeseen emergencies.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. This helped to protect the health and welfare of staff and people who used the service.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well nourished.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of their responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work related issues and ask for any training they felt necessary.

We observed there were good interactions between staff and people who used the service. People told us staff were kind and caring.

We saw from our observations of staff and records that people who used the service were given choices in many aspects of their lives and helped to remain independent where possible.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed.

There were sufficient activities to help keep people stimulated.

People were treated in accordance to their age, gender, sexuality and religion.

Plans of care were individual, person centred and reviewed regularly to help meet their health and social care needs.

Visiting was unrestricted so that people could remain in contact with family and friends.

Quality assurance audits helped the service maintain and improve their standards of support.

Nearly all the people we spoke with and staff thought the managers were approachable and supportive.

We last inspected this service in November and December 2016. The service did not meet all the regulations we inspected and were given requirement actions for medicines (no means to identity people who had a dementia), keeping people safe, the service did not always follow the principles of the Mental Capacity Act, complaints were not always responded to, accurate record keeping and the supervision and appraisal of staff. The service sent us action plans to show how they intended to improve. However, although the service had made some improvements since the last inspection, during this inspection we found one breach of regulation 12 (2) (g), the proper and safe management of medicines, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

The service did not have a registered manager although a person was due to be interviewed to be registered with the Commission . 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Since the inspection a person was registered with the Care Quality Commission..

Some aspects of medicines administration were not safe. Some of the medicines records were not signed for, had been administered incorrectly or were not sufficiently well documented to provide information for safe administration.

Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them, which included the contact details of the local authority to report to any incidents to.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

Staff were recruited robustly to help ensure they were safe to work with vulnerable people.

We saw there were good systems for the prevention and control of infection and staff wore personal protective equipment when required.

We saw the service followed the principles of the Mental Capacity Act to protect people’s rights.

People were provided with a suitable diet and were offered support if necessary. Professional help was sought where a person’s nutritional assessment showed they were at risk.

Staff received a suitable induction and training was ongoing. Staff were able to discuss their careers during regular supervision.

The environment was suitable for the people accommodated at the home.

People who used the service and their families thought staff were kind and caring. Staff were careful to preserve people’s dignity.

All records were stored securely and available for inspection including plans of care.

People who used the service had access to a complaints procedure and we saw that their concerns were investigated, as were any incidents and accidents.

People were provided with a range of activities suitable to their age and gender. This included access to clergy for their religious needs.

Plans of care contained sufficient information for staff to follow good practice to meet their needs. The plans were regularly reviewed to keep people’s health and social needs up to date.

People, relatives and staff thought the manager was supportive and available to talk to. They also said the service was much improved since the area quality manager, new manager, unit managers and clinical care lead had commenced working at the service.

Managers conducted a range of audits and acted upon any shortfalls to help improve the service.