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Inspection carried out on 17 October 2017

During a routine inspection

Quaker House offers accommodation for up to 40 older people. We carried out an unannounced inspection on 17, 19 & 20 October 2017. Thirty-one people were living in the home at the time of the inspection.

At our inspection in October 2016 we identified the provider was not meeting three regulations. Risk assessments were not always completed and regularly reviewed and actions were not taken to mitigate risks. Staff had not always followed safeguarding guidance to ensure people were protected from abuse or harm. Records in respect of people living at the home were not always accurate and up to date and the provider had not maintained appropriate oversight of the service. At this inspection we found that there was still some work to do to ensure risks to people were safely managed and the effectiveness of record keeping, which was sometimes out of date and did not reflect people’s current needs. We also found three new breaches of Regulations relating to people’s nutritional needs, the need for consent and person centred care.

The home had been through three management changes since our last inspection. At our inspection in October 2017 we found a new interim manager was in post until a new registered manager could be appointed. An advertisement went out for a registered manager the week after our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Initial assessments were carried out before people moved into Quaker House to ensure their needs could be met. Care plans were not always up to date and did not always reflect their current care needs.

Individual risks relating to people’s health, safety and welfare had not always been completed or adequately reviewed to identify, assess and reduce those risks.

Although staff received training to administer medicines and were assessed for competency, people had not always received their medicines at the correct time, and in some cases, they had not received their medicines at all. The interim manager had requested to the Board of Trustees to change the medicines management system.

People were not always supported to eat an appropriate diet that met their assessed nutritional needs and people’s food preferences were not always supported.

Not all staff understood and followed the principles of the Mental Capacity Act 2005 designed to protect people’s rights and ensure decisions were made in their best interests.

Most people told us there was not enough to keep them occupied and they were often bored. Staff confirmed they were often too busy providing care and did not have time to provide regular social or physical activities. There were sufficient staff deployed to meet people’s care and support needs.

People and relatives told us they felt the home was safe. Staff understood how to identify abuse and explained the action they would take if they identified any concerns. However, not all staff knew how to report concerns to external agencies such as the Care Quality Commission.

Some recruitment checks required improvement to ensure that only suitable staff were employed.

Staff had not all received appropriate supervision, appraisal and training in line with the provider’s policy although actions had been taken to address this.

The manager had a good understanding of their responsibilities in relation to meeting the Health and Social Care Act 2008 regulations. They had notified us appropriately of events required by law.

Systems were in place to monitor and assess the quality and safety within the home although this was a work in progress and recent action plans had not yet been implemented.

Incidents and accidents had been investigated and learning shared with staff.

People were supported to maintain their health and well-being and had access to a range of healthcare services when they needed them.

Staff interacted with people with kindness and care. Staff treated people with dignity and respect and ensured their privacy and independence was promoted.

Friends and family were able to visit their loved ones at any time and felt welcomed by staff.

Residents meetings took place and enabled people to share their views about the service. People and relatives knew how to raise concerns and would do so if they needed to.

Staff felt supported by the interim manager who provided clear leadership and direction. Staff felt able to raise any issues or concerns with them and felt listened to and involved.

We identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection carried out on 25 October 2016

During a routine inspection

Quaker House offers accommodation for up to 40 older people. We carried out an unannounced inspection on 17, 19 & 20 October 2017. Thirty-one people were living in the home at the time of the inspection.

At our inspection in October 2016 we identified the provider was not meeting three regulations. Risk assessments were not always completed and regularly reviewed and actions were not taken to mitigate risks. Staff had not always followed safeguarding guidance to ensure people were protected from abuse or harm. Records in respect of people living at the home were not always accurate and up to date and the provider had not maintained appropriate oversight of the service. At this inspection we found that there was still some work to do to ensure risks to people were safely managed and the effectiveness of record keeping, which was sometimes out of date and did not reflect people’s current needs. We also found three new breaches of Regulations relating to people’s nutritional needs, the need for consent and person centred care.

The home had been through three management changes since our last inspection. At our inspection in October 2017 we found a new interim manager was in post until a new registered manager could be appointed. An advertisement went out for a registered manager the week after our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Initial assessments were carried out before people moved into Quaker House to ensure their needs could be met. Care plans were not always up to date and did not always reflect their current care needs.

Individual risks relating to people’s health, safety and welfare had not always been completed or adequately reviewed to identify, assess and reduce those risks.

Although staff received training to administer medicines and were assessed for competency, people had not always received their medicines at the correct time, and in some cases, they had not received their medicines at all. The interim manager had requested to the Board of Trustees to change the medicines management system.

People were not always supported to eat an appropriate diet that met their assessed nutritional needs and people’s food preferences were not always supported.

Not all staff understood and followed the principles of the Mental Capacity Act 2005 designed to protect people’s rights and ensure decisions were made in their best interests.

Most people told us there was not enough to keep them occupied and they were often bored. Staff confirmed they were often too busy providing care and did not have time to provide regular social or physical activities. There were sufficient staff deployed to meet people’s care and support needs.

People and relatives told us they felt the home was safe. Staff understood how to identify abuse and explained the action they would take if they identified any concerns. However, not all staff knew how to report concerns to external agencies such as the Care Quality Commission.

Some recruitment checks required improvement to ensure that only suitable staff were employed.

Staff had not all received appropriate supervision, appraisal and training in line with the provider’s policy although actions had been taken to address this.

The manager had a good understanding of their responsibilities in relation to meeting the Health and Social Care Act 2008 regulations. They had notified us appropriately of events required by law.

Systems were in place to monitor and assess the quality and safety within the home although this was a work in progress and recent action plans had not yet been implemented.

Incidents and accidents had been investigated and learning shared with staff.

People were supported to maintain their health and well-being and had access to a range of healthcare services when they needed them.

Staff interacted with people with kindness and care. Staff treated people with dignity and respect and ensured their privacy and independence was promoted.

Friends and family were able to visit their loved ones at any time and felt welcomed by staff.

Residents meetings took place and enabled people to share their views about the service. People and relatives knew how to raise concerns and would do so if they needed to.

Staff felt supported by the interim manager who provided clear leadership and direction. Staff felt able to raise any issues or concerns with them and felt listened to and involved.

We identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection carried out on 31 July 2013

During a routine inspection

We were assisted throughout the inspection by the registered manager and members of staff. We spoke with eight people who lived at the home, three members of staff and with one person, who was about to move into the home and their relative.

People’s privacy dignity and independence was respected and promoted. People living at the home told us that they were fully involved in their care, that they were listened to and their choices and preferences respected.

People’s care and welfare needs were being met. Assessments had been carried out and care plans put in place so that staff knew how to support people.

The home had robust recruitment procedures in place that were being followed to ensure that suitable members of staff were employed to work at the home.

The home had effective systems in place to monitor the quality of service provided to people living at Quaker house.

Records were maintained on behalf of people. These were up to date, accurate and stored confidentially.

Inspection carried out on 1 October 2012

During a routine inspection

At this inspection we spoke with ten people who lived at the home, two members of staff, the registered manager and briefly with a member of the Board of New Milton Quaker Housing Association. Everyone we spoke with had positive things to say about the home, from the standards of care, the way the home was managed to the approach and support of staff.

People told us that they were consulted about their care and the way the home was run.

They told us their care needs were met by the staff team and that the home was well managed.

Staff we spoke with told us that they were felt supported by the management and that training was provided to make sure they were competent and knowledgeable.

Inspection carried out on 31 October 2011

During a routine inspection

People told us they received a good service from staff. They liked living at the home and were encouraged to remain independent .They said there were lots of activities to provide mental stimulation and support was available when they needed it.

Reports under our old system of regulation (including those from before CQC was created)