Archived: Catchpole Court Care Home

Catchpole Court is a care and nursing home for up to 66 older people, some of whom are living with dementia. The home comprises of two units, Constable and Gainsborough, and is arranged over two floors. At the time of our inspection there were 45 people living at the service.

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

Risks related to the environment had been assessed. However, we identified risks of scalding to people from a lack of thermostatic valves fitted to showers. In response to our findings the provider took immediate action to rectify this.

People told us care was provided safely by staff who had been recruited and employed after appropriate safety checks had been completed. There were systems in place to safeguard people from the risk of abuse and staff knew how to respond and report concerns they may have.

We noted unclean touch points such as door handles and light switches as well as equipment. We recommended cleaning schedules include evidence of regular touch point cleaning and cleaning of equipment such as commodes.

Our observations during the inspection, were of positive and warm interactions between staff and people. There was a system in place to respond to complaints received. People were supported to make plans for the end of their life.

Staff had received training relevant to their roles. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medicines were administered by staff who had received training and their competency to do so assessed.

The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. 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.

People were supported to eat and drink enough to ensure they maintained a balanced diet. Referrals to other health professionals were made when required. However, we recommended clinical audits include regular bowel monitoring to ensure timely action in response to people at risk.

There were systems in place to assess the quality and safety of the service and improve outcomes for people. Incidents and accidents were analysed for trends and any lessons learned shared with the staff team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update) The last rating for this service was require improvement (published 28 February 2020) where we identified a breach of regulation 18 in relation to staffing. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this inspection to check the provider had followed their action plan and to confirm they now met legal requirements.

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.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Catchpole Court on our website at www.cqc.org.uk.

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.

Catchpole Court is a care and nursing home for up to 66 older people, some of whom are living with dementia. The home comprises of two units, Constable and Gainsborough, and is arranged over two floors. Constable primarily provides residential care for older people and Gainsborough, nursing care for people living with dementia. At the time of our inspection there were 44 people living at the service.

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

There had been no manager in post since July 2019 despite the regional manager and provider’s efforts to recruit one. In addition, there had been a reliance on agency staff to cover many care shifts due to personnel changes. This had impacted on the running of the home.

Ineffective staffing deployment and management and oversight arrangements meant there was limited time for staff to support people with activities, and at times, there was limited social interaction. We have made a recommendation about this.

People’s meal time experience would benefit from further review and co-ordination. We have made a recommendation about this.

The management team were responsive and open to discussions and committed to making any necessary improvements.

Staff had a good understanding of how to recognise and report potential harm or abuse and were confident the provider would take action in line with local safeguarding procedures.

People received their medicines as prescribed. Staff sought advice and assistance from health professionals and routine health appointments were made for people where needed.

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. The provider was working within the principles of the Mental Capacity Act.

Staff received an induction and ongoing training and support to fulfil their role and extend their knowledge.

Staff were very kind and caring and had good relationships with people. They understood people's needs and preferences and provided personalised care.

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 6 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good …

Staff knew how to respond to possible abuse and how to reduce risks to people individually and from environmental risks, such as from equipment or through fire safety awareness. There were usually staff who had been recruited properly to make sure they were safe to work with people. Medicines were stored and administered safely.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005. 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 received a choice of meals and staff supported them to eat and drink enough. They were referred to health care professionals as needed and staff followed the advice professionals gave them.

Staff were caring and kind and treated people with respect. People’s right to privacy was maintained by the actions and care given by staff members.

People’s personal and health care needs were met and care records guided staff in how to do this. There were not enough activities or things for people to do during the day and people did not always have enough social stimulation. Complaints were investigated and responded to and people knew who to go to, to do this.

Staff worked well together and felt supported by the management team. The monitoring process looked at systems throughout the home, identified issues and took the appropriate action to resolve these.

Further information is in the detailed findings below.

We also spoke with eight people who used the service and with six staff members. We looked at seven people's care records and other records including health and safety checks, staff and resident meeting minutes and the result of the satisfaction survey that had been carried out by the service. We also talked with the manager and the area manager.

We looked around the building and assessed it for cleanliness and safety.

During our inspection and in the analysis of our findings, we considered the questions we always ask; Is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found;

Is the service safe?

We did not find that all areas of the service were safe.

When we arrived our identification was checked and we were asked to sign the visitor's book. This showed that the staff took the security of the building and the safety of the people who lived there seriously.

We found that staff had received training in protecting vulnerable people from harm and how to make a referral to the local authority for further investigation under their safeguarding procedures. When we spoke with people they told us they felt safe living in the home and that they would speak with the staff if they had concerns.

Our records showed that the service had acted quickly if they had any suspicion of abuse and acted on if they considered people were at risk of abuse.

We saw that the staff were provided with training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were only deprived of their liberty when they needed to be so that they were kept safe, and if they were deprived it was only done in their best interest.

We saw records which showed that the health and safety and infection control checks had been carried out in the service regularly, but we found areas of the service that were unsafe, poorly maintained and unhygienic.

We saw that there were sufficient staff on duty, but that they could be better deployed to protect people's health, safety and wellbeing. The staff rota and dependency level assessments showed that the service assessed people's needs to ensure that there were sufficient numbers of staff to meet them.

But at key periods sufficient numbers of staff were not available to support people with their meals. This was because staff left the floor to have their scheduled meal breaks during the main mealtime. Nor was it clear that the activity coordinators used their time effectively, and poor infection control and cleanliness in the service indicated that there were not enough domestic staff available to keep the home clean and safe.

People told us that the staff were available when they needed them. One person said, "I don't have to wait long for help." Another person told us that, 'They (the staff) are never far away if I need them.' Staff told us that there were times when they were busy and found it difficult to cope, especially at mealtimes.

We identified poor moving and handling practice on two separate occasions.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

However, during our observations we saw that people on the Gainsborough unit displayed agitated, distressed, bored, and disconnected behaviour. We saw that there was little evidence that the service provided activities specifically designed to engage people living with dementia. The staff were seen to be rushed and stressed, which meant that we could not be assured that the people who used the service had access to meaningful activities to enable them to remain engaged and motivated.

The provider had a quality assurance system in place and the records we examined showed that health and safety audits had been done. However, due to our concerns found during this inspection, it is not evident that these audits were effective in keeping people safe and ensuring that the service was meeting their needs.

Is the service caring?

We saw that the majority of staff interacted with people who lived in the home in a caring, respectful and professional manner. However there were times when we saw that staff did not interact with people in a way that would ensure that they felt well supported and safe.

People who spoke with us, mainly on the Constable unit, told us that the staff treated them with respect. One person said that staff were, "Kind people." Another person told us, "I couldn't find anything to complain about."

Is the service responsive?

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including the doctor, district nurse and dietician.

The people who used the service, their relatives and other professionals involved with Catchpole Court who had completed the satisfaction questionnaires said that they felt that the service responded well to concerns raised with them. Where shortfalls or concerns had been raised they were dealt with quickly.

Is the service well led?

The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say. The manager also told us that they felt supported by the organisation and by their direct line manager, who visited the service regularly to offer support and to check compliance.

Our observations suggested that people living at the service were happy, that they felt safe and were well cared for. It was evident that people who used the service had a good relationship and rapport with the staff who supported them.

People's health and personal care needs were assessed and there were care plans in place for care staff to follow so as to ensure that people were supported safely and in accordance with people's individual preferences and wishes. Staff spoken with demonstrated a good understanding of people's health and personal care needs and how each person wished to be supported. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

The provider was able to demonstrate that a robust staff recruitment policy and procedure was in place and followed to ensure that people living at the service were kept safe. We found that there were sufficient numbers of staff available to meet people's care needs. We found that medication practices and procedures required minor improvement.

We found that there had been changes to the day-to-day management of the home and the service was currently being managed by the deputy manager.

People told us that they found the standard of meals was good with one person stating that 'I always eat everything.' But another person stated that they found that all the food had an 'underlying taste, not sure what it is but everything tastes quite similar.'

One person stated that "There is always someone to help me and have a laugh with." Another person commented that "There is a homely and welcoming atmosphere here.'

We found that the service was meeting the personal, emotional and healthcare needs of people using the service. We found that the environment was maintained safely and odour free and that all health and safety checks were up to date.

We found that all mandatory training was up to date.