Archived: Church View Care Home

Updated 22 January 2020

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by three inspectors, a specialist nurse advisor 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

Service and service type:

Church View Care Home is a 'care home'. People in care homes receive accommodation and nursing care as a single package under one contractual agreement CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced.

What we did before the inspection:

We reviewed the information the registered manager sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed the notifications received from the provider, since the last inspection. The law requires providers to send us notifications about certain events that happen during the running of a service. We contacted local authority teams engaged with the service for information to aid the planning of our inspection. We used all this information to plan our inspection.

During the inspection:

We spoke with 11 people who used the service about their experience of the care provided. We spoke with six members of staff including the registered manager, deputy manager, nurses, care staff and activity staff. We also spoke with six relatives who had visited the home on the day of inspection.

We reviewed a range of records. This included ten people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection:

We received additional information from the registered manager that we had requested on the day of the inspection. This included staff and residents meeting minutes where available, satisfaction surveys and the providers continuity plan in case of an emergency.

Updated 22 January 2020

About the service:

Church View Care Home is a ‘care home’ providing personal and nursing care for up to 78 people. The service is provided in one adapted building which is divided into six wings, each with their own lounge and dining area. At the time of our inspection 61 people were living at the service and was currently only using five of the six wings.

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

Risk to people’s safety and well-being were not always monitored effectively. Guidance was not always available to support people with some specific conditions and behaviours and staff required support to develop skills in this area. The support people received was often task focussed and activities did not always reflect people's hobbies and interests. Individual caring interactions with people were seen. However, we found on some occasions people's dignity was not respected.

There were enough staff deployed to meet people's needs. However, we found that some staff had not always understood their responsibility in protecting people from potential abuse by not always reporting incidents and accidents.

People received their medicines safely and had access to healthcare professionals when required. A choice of foods was available, and people told us they enjoyed their meals. People spoke positively about living at the home.

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.

People did not always have detailed care plans in place to reflect their needs. We found that although there were some good examples of care planning in place for people this was not consistent across the home. We identified significant gaps in some people’s care plans where certain specific conditions had been documented but had no further guidance or assessment.

Staff respected people's privacy when supporting them with personal care. Although we did observe one incident where this did not happen, and this was raised with the registered manager. We observed instances of staff taking time to support people to make decisions and choices regarding how they wished to spend their day.

Engagement with relatives was not always happening. Meetings had been set up however only one relative had attended a meeting in 2019. The registered manager said they were looking at other methods to advertise the meetings such as emailing relatives to try and improve awareness.

Quality assurance processes were in place however these had failed to identify the areas of concern we found on inspection. Some negative cultures had appeared with regards to staff attitudes and thinking towards how people are supported. The management team had not been robust in inflicting change to these negative cultures despite knowing there was a concern.

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 06 April 2018).

Why we inspected:

The inspection was prompted in part due to concerns received about the care people received. A decision was made for us to inspect and examine if people were receiving safe care.

Enforcement:

We have identified breaches in relation to the management of risks to people's safety, person-centred care, the activities provided and the management oversight of the service. Please see the action we have told the provider to take at the end of this report.

Follow up:

We will continue to monitor intelligence 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