Archived: Venetia Care Home

Updated 25 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 29 March 2017 and was unannounced.

The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed the information we held about the service including notifications received from the provider. CQC requires that certain incidents, events and changes that affect a service or the people using it are notified to CQC as notifications.

During the visit we spoke with six people living at the service. We inspected all communal rooms and looked in three bedrooms.

We spoke with two support workers and the registered manager.

We looked at the three people’s care records and risk assessments. We looked at three staff recruitment files and training records for seven staff. We looked at supervision records for five staff.

We looked at systems for managing medicines. We checked documents related to the maintenance of the building, the accident/incident folder and meeting minutes related to staff discussions and meetings for people who live at the service.

As part of the inspection process we spoke with two health and social care professionals.

Updated 25 May 2017

We inspected this service on 29 March 2017. The inspection was unannounced. Venetia Care Home is registered for a maximum of eleven adults who have mental health needs. At the time of our inspection there were nine people living at the service.

The service is located in two large adjoining houses, one located in Venetia Road, the other Lothair Road, on two floors with access to a back garden.

We previously inspected the service on 16 August 2016 and found the service was in breach of seven regulations relating to governance of the service, insufficient staffing levels, safeguarding, safe care and treatment, person centred care, need for consent and dignity and respect. As the overall rating for the service was ‘inadequate’ this service has been in Special Measures.

Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and it is no longer rated as inadequate overall or in any of the key questions. We have also had positive feedback on improvements at the service from health and social care professionals. Therefore, this service is now out of Special Measures.

At the time of the inspection there was a registered manager employed by the service. A registered manager is a person who has registered with the Care Quality Commission 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.

On the day of the inspection, the atmosphere was calm and relaxed. We saw staff were kind and caring to the people living at the service and the people living at the service confirmed staff were friendly and available to support them. We were confident people were treated with dignity and respect.

At the inspection in August 2016 we had concerns regarding the cleanliness of the service. At this inspection we found the premises were clean throughout. The kitchen was clean and the majority of food produce in the fridge was labelled and sealed. We saw there were labels available and the provider had purchased containers to store opened food. However, a new staff member had left a meat product covered but not labelled and cooked vegetables were uncovered from dinner the previous evening. This was immediately remedied.

At the previous inspection we were concerned there was insufficient staffing to safely meet the needs of people living at the service. At this inspection staffing levels had increased and new staff had been recruited. At the time of this inspection the provider and commissioners were liaising regarding increased overnight cover at the service. Three people needed supervision if they left the building, and there was no staff member awake at night at the service. In the meantime the registered manager told us she had risk assessed this situation and in her view, no-one was at risk as a result of current staffing levels.

Staff told us the increase in day staff had enabled them to support people to do more activities. People told us they had joined a choir group and sang songs they had learned accompanied by a staff member and another person who played guitar, in the evenings at the house.

Previously we had concerns related to the way the service was operating in relation to providing person centred care as set routines were in place. At this inspection we saw that people had been asked their views as to how they wanted their medicines provided, and although the kitchen remained locked for set periods, people could now make hot drinks or get fruit drinks from the open kitchen next door as they wished. A shower room previously closed off was now available for people to use when they chose to.

In the period between August 2016 and March 2017 we were notified appropriately of any safeguarding issues that had occurred and the provider had liaised appropriately with other relevant organisations.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). The service had DoLS in place for those who needed it.

At the last inspection the provider could not evidence they had the authority to restrict specific people’s liberty or their access to cigarettes. At this inspection we saw that relevant documentation was in place where required and consent was gained from people with mental capacity if the service was safekeeping their belongings, or assisting them with managing their cigarette intake.

In August 2016 we were concerned as there was an absence of effective quality monitoring systems in place for key areas, and this had impacted on the quality of the service offered. We found regular supervision and training were not taking place, many procedures and policies were outdated and quality audits, for example related to cleaning, had not prompted improvement. Between August 2016 and March 2017 records showed staff had undertaken training in key areas and had been regularly supervised. Procedures were updated and there were quality audits taking place and actions followed through as required, and this had resulted in significant improvements at the service.

We have made a recommendation in relation to person centred care at the service.