Regents View Care Home

Regents View Care Home is a residential care home providing personal and nursing care for up to 50 people. At the time of our inspection there were 48 people using the service.

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

There were not enough staff on duty to meet people’s needs. The provider had not ensured risks to people had been assessed, monitored and managed. Recruitment processes had not been safely managed.

The provider's fire risk assessment was over 12 months old and although action was taken to address this after the inspection, the provide'rs own quality assurance systems had not identified this.

The home required refurbishment. Many areas of paintwork, flooring and furniture were worn. Curtains and blinds were missing from windows. The manager sent us a refurbishment plan after the inspection detailing the refurbishment to be carried out and timescale for completion.

Some quality monitoring systems were ineffective as they did not identify the areas of concern we found during this inspection.

Most people and relatives said they felt safe at the service and staff were kind and caring. However, some relatives did raise concern about some staff ignoring people or being rude.

People received support with their medicines and there were measures in place to prevent the spread of infections.

Accidents and incidents were well managed, with procedures in place to learn from these.

The provider had an open, transparent culture. People and staff all had opportunities to provide feedback about the service which was used to drive continuous improvement. Staff enjoyed their jobs and were all keen to deliver high-quality care. The manager and staff worked alongside other professionals to help ensure people received effective care and support.

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.

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 11 July 2023).

Why we inspected

The inspection was prompted in part due to concerns received about the overall management of the service, limited activities, and the safety of care of people who use the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. Please see the full report for further details.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Regents View Care Home on our website at www.cqc.org.uk

Enforcement

We have identified breaches in relation to safe care and treatment and the provider's oversight and management of the service.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Regents View Care Home is a residential care home providing personal and nursing care to up to 50 people. The service provides support to older people, some of whom were living with dementia. At the time of our inspection there were 50 people using the service.

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

Care plans described how to manage potential risks, however there were no specific risk assessments. The registered manager acted immediately to implement these.

People and relatives gave positive feedback about the care provided at Regents View Care Home.

Staff knew how to identify and report safeguarding concerns. Previous safeguarding concerns had been referred to the local authority and investigated. Management investigated incidents and accidents and acted to help prevent future occurrences. The home was clean and tidy throughout. There were enough staff to meet people’s needs and new staff were recruited safely. Medicines were administered safely.

Staff were well supported and received the training they needed. Staff supported people to have enough to eat and drink and to access healthcare services, when required.

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 had a structured approach to quality assurance, which had been effective in identifying areas for improvement. People, relatives and staff had good opportunities to provide feedback. The registered manager and staff team had positive relationships with external stakeholders and professionals.

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 23 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The home had comprehensive policies and procedures to manage any risks associated with the COVID-19 pandemic. This included the management of people with a COVID-19 positive diagnosis. The policies and procedures were updated regularly following any changes in national guidance.

People living in the home and their relatives were supported to maintain contact. When visitors were unable to access the home, for example if they tested positive for COVID-19 technology such as online visiting was utilised.

A programme of regular COVID-19 testing for both people in the home, staff, essential carers and visitors to the home was implemented. All visitors, including professionals were subject to a range of screening procedures, including showing evidence of vaccination and a negative lateral flow test before entry into the home was allowed.

There was an ample supply of PPE for staff and any visitors to use. Hand sanitiser was readily available throughout the service. Staff had received updated training on the use of PPE and we observed staff wearing it correctly during out inspection. Clear signage and information was in place throughout the home to remind staff of their responsibilities.

Daily cleaning schedules were implemented by housekeepers and all staff were involved in undertaking touch point cleaning.

We previously inspected Regents View Care Home in October 2015, at which time the service was compliant with all regulatory standards and was rated Good. At this inspection the service remained Good.

Regents View is a care home in Hetton-le-Hole, Sunderland, providing nursing, accommodation and personal care for up to 50 older people. There were 40 people using the service at the time of our inspection, the majority of whom were living with dementia. This included a male-only area of the home, where there were currently eight people using the service.

The service had a registered manager in place. 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.

People were protected by staff who understood specific risk assessments and care plans. Risks were reviewed and acted on with the input of external professionals where appropriate.

People and their relatives told us there were ample staff. The registered manager and some staff acknowledged the workload could be particularly challenging when there were unexpected staff absences and they were recruiting more staff in an attempt to reduce this likelihood and impact.

Staff demonstrated a good awareness of safeguarding principles and had received refresher training on the subject, as well as recent moving and handling refresher training.

The management, administration, storage and disposal of medicines was in line with the National Institute for Health and Care Excellence [NICE] guidelines.

The laundry used a ‘dirty in clean out’ two door system and was in good order. We found the home to be clean and well maintained.

Pre-employment checks were made to reduce the likelihood of employing people who were unsuitable to work with potentially vulnerable people.

Breakaway training, in order to equip staff with the skills to safely remove themselves from a physical altercation, had yet to be delivered. All other mandatory training was in place and monitored regularly. This included health and safety, fire safety, infection control, mental capacity, food hygiene and dementia awareness.

Kitchen staff demonstrated a strong awareness of people’s dietary requirements and preferences. Mealtime experiences were varied and sometimes people had to wait for their meals.

The registered manager was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). They had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. 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.

There were some dementia-friendly aspects to the environment, for instance wide, bright corridors with contrasting walls, tactile murals on walls. Other areas, particularly the male-only area, required refurbishing with people’s needs in mind.

Staff received consistent support through supervision and appraisal meetings, as well as staff meetings.

People who used the service, relatives and external professionals agreed staff were caring in their approach to people and we observed evidence of this during our inspection. People were treated with dignity and respect.

Care plans contained sufficient person-centred information and staff had a good knowledge of people’s needs, likes and dislikes.

The service had a full time activities co-ordinator. Weekly activities and outings were planned although more could be done to ensure people in the male-only area of the home had access to a range of activities meaningful to them.

People’s changing healthcare needs were reviewed and external advice and support was sought and acted on regularly.

There were a range of checks and quality assurance processes in place to review the systems in place and outcomes for people. The registered manager took a lead on this auditing work and was supported by the area manager. They made appropriate notifications to CQC and liaised with external stakeholders to source training and other opportunities.

Relatives we spoke with, staff and external professionals were positive about the approachability and effectiveness of the registered manager. We found the culture to be a hard-working one, which focussed on people feeling secure and well cared for.

We spoke to one person who told us they were 'happy'. We spoke to two relatives. One told us they thought the care home was 'fantastic' the staff always kept them informed and the food was good. The other person said their relative was 'very settled' in the care home and the staff treated them with dignity and respect and also they knew their needs well. Both people we spoke with confirmed that they thought their relatives were safe.

We found people's privacy, dignity and independence were respected and people experienced care, treatment and support that met their needs and protected their rights. People who use the service were protected from the risk of abuse and people were cared for by suitably qualified, skilled and experienced staff. The provider had an effective system to regularly assess and monitor the quality of service that people receive.