9 December 2020
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.
As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.
This inspection took place on 24 November 2020 and was announced.
9 December 2020
About the service:
The Old Hall Residential Care Home is registered to provide accommodation and support for up to 25 people, including people living with dementia. There were 15 people living in the home on the first day of our inspection.
In December 2017 we rated the home as Inadequate and placed it in Special Measures, reflecting the registered provider’s failure to address regulatory breaches identified at previous inspections. We also imposed an additional condition of registration to prevent the registered provider from admitting anyone to the home without our prior permission. When we inspected the service again in August 2018 we were disappointed to find little evidence of improvement. The service was again rated as Inadequate and remained in Special Measures.
People’s experience of using this service:
Since our last inspection in August 2018 the registered provider (‘the provider’) had appointed a new manager who was now registered with the Care Quality Commission. Under the leadership of the new registered manager, all of the regulatory breaches identified at previous inspections had been addressed. Aside from one administrative shortfall in the provider’s staff recruitment system, significant improvement had also been made in other aspects of service provision.
Staff worked together in a mutually supportive way and communicated effectively, internally and externally. Training and supervision systems were in place to provide staff with the knowledge and skills they required to meet people’s needs effectively. There were sufficient staff to meet people’s care and support needs without rushing. Staff provided end of life care in a sensitive and responsive way.
Staff were kind and attentive in their approach and were committed to promoting people’s dignity, privacy and respect. People were provided with food and drink of good quality which met their individual needs and preferences. There was a programme of regular activities and events to provide people with physical and mental stimulation. There was an ongoing programme of improvement to the physical environment and facilities in the home.
Staff worked alongside local health and social care services to ensure people had access to any specialist support they required. Systems were in place to ensure effective infection prevention and control and people's medicines were managed safely. Staff were aware of people’s rights under the Mental Capacity Act 2005 and supported people to have maximum choice and control of their lives, in the least restrictive way possible. The policies and systems in the home supported this practice.
People’s individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm, although improvement was required to ensure staff recruitment procedures were consistently safe.
The registered manager provided strong but supportive leadership and in her five months in post had won the respect and loyalty of her team. A range of audits was in place to monitor the quality and safety of service provision. To help ensure the improvement in service quality was sustained, the registered manager maintained a hands-on role in all areas of the home and the owner had increased his involvement. Systems were in place to promote organisational learning from significant incidents and events. Formal complaints were rare and any informal concerns were handled effectively.
Rating at last inspection:
Inadequate (Published November 2018)
Why we inspected:
This was a planned inspection based on the rating at the last inspection. As described above, at this inspection we were pleased to find significant improvements in service quality. As result, the rating of the service is now Good and the service is no longer in Special Measures. We have also advised the provider we plan to remove the additional condition of registration imposed following our December 2017 inspection.
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.