Serene Residential Care Limited

Updated 30 June 2022

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 Health and Social Care Act 2008.

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

One inspector carried out the inspection.

Service and service type

Serene Residential Care 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.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. We visited the service on the 23 May 2022.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority partners, including quality monitoring teams who work with the service. We used all this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with three people who used the service and two visiting relatives, to seek their feedback about the service provided. We spoke with three members of staff, the operations director, the cook and activity staff.

We reviewed a range of records. These included the care records for two people, two staff recruitment files, audits and monitoring systems and health and safety checks. We also looked at the management and administration of people’s prescribed medicines.

After the inspection

We contacted three people's relatives by telephone and continued to seek clarification from the provider to validate evidence found.

Updated 30 June 2022

About the service

Serene Residential Home is registered to provide accommodation for up to 35 people aged 65 and over who require personal care, some of whom live with dementia. At the time of our inspection there were 13 people living at the home.

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

The service had significantly improved since the last inspection. People, their families, staff, stakeholders and health professionals all recognised the improvements. Feedback was positive about the care and support people received.

The premises were clean and there was improved infection control practice consistently in place. All individual risks for each person had been reviewed and were understood by staff. Care plans and risk assessments had been updated and there were clear systems to communicate new risks to staff. Where we saw one potential hazard, this was addressed immediately. Records were up to date and senior care staff had been given time to check and update these throughout the day. Work was in progress to further enhance care plans with personalised information about people’s individual needs and wishes.

There was significant improvement in people’s dietary needs and risks. The cook worked with people and families, menus had been updated and there was clear risk information around modified diets, thickeners, choke risks and diabetes. 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.

Staffing levels supported people’s needs well. An activities coordinator was in post and people were engaged in a wide range of activities as well as having individual time in conversation. Recruitment processes were robust, staff induction, supervision and training was updated. The provider had strengthened the management team, with the appointment of an operations director to complement the registered manager’s skills and abilities. New governance systems were put in place as well as robust checks for health and safety, staff practice and overview of risk. Audits were regular and thorough and a resident risk meeting was held weekly, with an overview of all risks updated and shared with staff. Records had vastly improved and were still being updated with person-centred language and involvement from families and people who used the service. The environment had been refurbished and there was a wide range of resources and activity areas, as well as private visiting space and relatives’ lounges for social visits. Signage was clear and rooms were very personalised with people’s belongings and photographs.

There was clear evidence to show the service had worked hard to address the breaches found at the last inspection and was continuing to drive improvement.

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 Inadequate and there were multiple breaches of regulation (published 25 November 2021). The provider completed an action plan after the last inspection to show what they would do, and by when, to improve.

This service has been in Special Measures since November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

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

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

During this inspection we carried out a separate thematic probe, which asked questions of the provider, people and their relatives, about the quality of oral health care support and access to dentists, for people living in the care home. This was to follow up on the findings and recommendations from our national report on oral healthcare in care homes that was published in 2019 called ‘Smiling Matters’. We will publish a follow up report to the 2019 'Smiling Matters' report, with up to date findings and recommendations about oral health, in due course.

Follow up

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