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Archived: Partridge Care Centre Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 June 2016

The inspection took place on the 5 May 2016 and was unannounced. Partridge Care Centre is a purpose built home set over three floors. It provides personal and nursing care for up to 117 older people, some of whom live with dementia. At the time of our inspection 65 people were using the service. Following our inspection of the service on 23 July 2015 we imposed a condition on the provider’s registration to prevent them from admitting any further people to Partridge Care Centre because of the concerns that we found. This condition remains in place.

At the time of our inspection there was a manager who had been in post for nine weeks but they had not registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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. However, following our inspection we were informed that the manager had left the service.

When we last inspected the service on 14 and 15 January 2016 we found the provider was not meeting the required standards. We found breaches of the Regulations in relation to safe care and treatment, staffing, safeguarding people, consent, privacy and dignity, person-centred care, meeting nutritional and hydration needs, receiving and acting on complaints and good governance. At this inspection we found that some improvements had been made although systems to sustain improvements were still under development.

People told us they received care from staff which was safe and met their needs. The provider was using a high number of agency staff to cover for staff vacancies and planned and unforeseen absences. When we last inspected the service the high use of agency staff was poorly managed and put people at risk of harm due to the lack of information given to agency staff. We found that this had improved and agency staff working at the service were regular, pre-booked for a longer period of time to help ensure people had consistency in the care they received.

People were assisted by care staff who had been trained and had their competency assessed to help ensure the care provided to people was safe and met their needs. We found that staff followed recommendations from social and health care professionals involved in people`s care. However, we found that not all the nursing staff working at the service had the necessary skills and knowledge required to meet the needs of the people living at the home.

When we last inspected the service in January 2016 we found that people’s freedom of movement had been restricted and restrained in ways that did not comply with nationally recognised good practice or the deprivation of liberty safeguards (DoLS). At this inspection we found that the manager has stopped these practices and where people required restrictions to their freedom, this had been done following the right processes.

Accidents and incidents were monitored and reported to the local safeguarding team and CQC where necessary and appropriate. We found that the internal systems to identify trends and patterns had improved and the manager and a consultant were working to develop the system further to ensure information and learning points were shared with staff to prevent accidents and incidents from reoccurring.

We found that both permanent and agency staff`s knowledge about safeguarding people from harm or any possible abuse had improved since the last inspection. Staff were able to tell us the process of reporting any concerns both internally and externally. Information about safeguarding and contact details for the manager and external safeguarding authorities were prominently displayed around the home.

Safe and effective recruitment practices were followed to check that staff were of good character, physically and mentally fit for the role and able to meet people’s needs. However, there was still a high turnover of staff as the provider was not able to recruit and retain a permanent staff group.

We found that people had their medicines administered by nurses who were trained and had their competencies monitored by the manager. There were regular audits carried out in relation to medicines. However we found that records for administered medicines had not always been signed by the staff responsible. One person had missed two doses of their medicine, although this had been available staff had recorded that it was out of stock.

Records were reflective of people`s needs and were regularly reviewed by staff. We saw that improvements had been made to care records in relation to person centred information about people`s likes and dislikes. The manager, deputy manager and clinical lead had held meetings with relatives and people who used the service and involved them in reviewing their plan of care.

People had mixed views about the quality of the food provided. Although it was in sufficient quantities people told us that the choices and alternatives offered if they were not happy with the main meal on offer were not appropriate for main meal choices, like sausage rolls.

All the people we talked with and their relatives were highly complementary about the new manager. Everybody knew the manager by name although they had only been in the service since March 2016. People told us they had faith that anything they asked for or reported to them was taken seriously and resolved.

Staff told us they were well supported by the new manager and they appreciated how approachable and open they were. Staff told us the new manager had put systems in place to improve the service people received and that they were consistent in imposing high standards of care.

Inspection areas

Safe

Requires improvement

Updated 22 June 2016

The service was not always safe.

People’s medicines were not always managed safely by staff.

Accidents and incidents were monitored, however information on trends and patterns and lessons learned were not always shared with staff.

Permanent and agency staff were able to describe how to recognise and report allegations of abuse.

There were a high number of agency staff used however staff were available in sufficient numbers to meet people`s needs safely.

Risks to people`s health and welfare were identified. Up to date plans were in place to mitigate the risks to help keep people safe.

Staff who worked at the service were employed following robust recruitment processes.

Effective

Requires improvement

Updated 22 June 2016

The service was not always effective.

Not all the nursing staff had the right skills and knowledge to meet people`s needs.

People`s day to day needs were met effectively, however people reported a difference between the quality of the care provided by permanent staff and agency staff.

Mental capacity assessments and best interest processes were followed and staff asked people for their consent before they delivered care.

Deprivation of Liberty Safeguards applications were submitted to the relevant authorities detailing the restrictions in place if people were deprived from their liberty.

Permanent and agency staff were supported and had received training to develop their skills to meet people’s needs effectively.

Caring

Good

Updated 22 June 2016

The service was caring.

Staff showed respect to people, they were kind and caring in their approach.

People and their rightful representative were involved in planning and reviewing their care.

Staff showed empathy, patience and a calm approach when caring for people who lived with dementia.

People`s dignity and privacy was respected and promoted by staff in most circumstances.

Responsive

Requires improvement

Updated 22 June 2016

The service was not always responsive.

People had comprehensive care plans to detail their physical and health needs. Staff were working to update care records with details about people`s life history, preferences, likes and dislikes.

Activities provided were varied, however people who were in their bedrooms all the time had little opportunities for individual activities.

People, staff and relatives told us their voices had been listened to by the new manager which had given them confidence in the service.

Complaints were appropriately logged, however there were not always appropriately investigated and responded to.

Well-led

Requires improvement

Updated 22 June 2016

The service was not always well led.

Daily observation charts were not always completed by staff.

The service was not always well led.

At the time of our inspection there was a newly appointed manager in post who had worked in the service for nine weeks. The manager had not registered with the CQC. The manager left the service shortly after our inspection visit.

The manager had started to develop systems to monitor and improve the quality and safety of the service provided but these were not yet effective in sustaining improvement.

Staff deployment had improved across the service and staff told us that the manager had ensured they had appropriate support by working alongside them and giving direct guidance.

Staff were complimentary about the leadership skills of the manager who they told us promoted an open culture and high standards of care.

Care records, risk assessments better reflected people’s needs and work was being done to personalise the care records with people`s likes and dislikes.

People and relatives knew the manager by name just after a few weeks of them managing the service. They told us they had trust and confidence in their ability to improve the quality of the care provided.