Background to this inspection
Updated
7 August 2021
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the specific concerns we had about management of blood thinning medicines, staffing and management of risks associated with percutaneous endoscopic gastrostomy (PEG).
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
This inspection was undertaken by one inspector.
Service and service type
The Close 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.
The service had two managers who were in the process of registering with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received about the service since the last inspection. We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern. We used all of this information to plan our inspection.
During the inspection
We briefly interacted with three people. We spoke with the two managers, two nurses and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records and medicine administration records (MAR). We looked at two staff rotas and allocation sheets. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
7 August 2021
About the service
The Close Care Home is a care home providing personal and nursing care for up to 90 people with a range of conditions. At the time of our inspection there were 80 people using the service. The accommodation is divided over four areas. Two registered managers were jointly responsible for the management of the service. There were extensive, attractive grounds that were easily accessible for people to enjoy. There was a Bistro that formed a central social space which was enjoyed by people and their relatives.
People's experience of using this service and what we found
The provider, registered managers and staff showed exceptional skill and innovative thinking when looking for ways to reduce risks for, whilst encouraging and enabling maximum independence. People were protected from the risks of abuse and felt safe living at the service.
People were supported to achieve highly positive outcomes through the strength of their relationships with staff. The management and culture of the service demonstrated a caring approach and staff were also valued and cared about. People were treated with the utmost respect and their dignity was continually upheld. This was confirmed by people and their relatives who provided exceptional feedback.
People received a truly person-centred service which included supporting their independence and having control over their lives. People received care and support that was personalised to meet their individual needs.
People received highly effective care and support from staff who knew them well and were well trained. People's rights to make their own decisions were protected. Staff worked well together for the benefit of people and were completely focused on meeting the personal, health and social care needs of people living at the service.
The provider, registered managers and staff team were highly motivated and proud of the service they delivered to people. There were consistently high levels of engagement with people using the service, families and other professionals. There was a strong commitment to ensure the service was inclusive and that people had the opportunity to extend their lives in the community.
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.
People were treated with exceptional care and kindness. They and their relatives thought very highly of the staff and praised their caring, thoughtfulness and willingness to go above and beyond for them. The provider, registered managers and staff had created lasting and meaningful relationships with people.
People's diverse needs were identified and met and their right to confidentiality was always protected. Staff recruitment and staffing levels supported people to stay safe while going about their daily lives. Medicines were handled correctly and safely. People were fully involved, and the provider was open and transparent when things went wrong.
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 19 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.