Background to this inspection
Updated
26 February 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by three inspectors. Two inspectors visited the home for one day and one inspector reviewed evidence and made telephone calls for four days.
Service and service type
Vestige Healthcare (West Bromwich) is a ‘care home’. People in care homes receive accommodation and nursing or personal 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 who had applied to be registered with the Care Quality Commission, the registration process had not yet been completed. This means 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 information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and two relatives about their experience of the care provided. We spoke with eight members of staff including the nominated individual, manager, nursing staff, care workers and domestic staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with two professionals who work with people who live in the service.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two 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.
Updated
26 February 2021
About the service
Vestige Healthcare (West Bromwich) is a residential care home providing personal and nursing care, treatment of disease disorder and injury and diagnostic and screening procedures. People living at the home have a mental health diagnosis and are aged 18 and over. Some people also had a learning disability or autism. The service can accommodate 14 people, at the time of inspection, nine people were living in the home.
People’s experience of using this service and what we found
Improvements had been made since the last inspection but there were still some areas that required improvement. A new audits system was being implemented but had not yet been used. Medicines records were not always accurate or up to date. Care plans and risk assessments had been reviewed and updated, however we found some information was not always consistent.
People, relatives and staff expressed confidence in the manager. Safeguarding processes were in place to report concerns to relevant professionals. There were enough staff to keep people safe.
We were assured the home had good infection control practice relating to COVID-19. Risks to people had been assessed and mitigated.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care and setting maximises people’s choice, control and independence.
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 requires improvement (published 01 November 2019) and there were two breaches of regulation. At this inspection we found improvements had been made however the provider were still in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We inspected other services owned by the provider and concerns were identified. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vestige Healthcare (West Bromwich) on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.