Background to this inspection
Updated
9 October 2019
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 one inspector.
Service and service type
Swarthmore Housing is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 information we had received about the service since the last inspection.
We used the information the provider sent us in the provider information return (PIR). 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.
During the inspection
We spoke with three people who used the service and two relatives about their experience of the service. We spoke with three members of care staff, the registered manager, the deputy manager and the visiting community nurse.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records this included five people’s care plans and each person’s medication administration record (MAR). We looked at four staff files in relation to recruitment and supervision. We viewed a range of records relating to the way the service was run.
After the inspection
We contacted relatives by phone and requested from the provider additional records relating to the service.
Updated
9 October 2019
About the service
Swarthmore Housing Society Limited is a residential care home it is registered to provide personal and nursing care for up to 40 people. At the time of the inspection 29 older adults were being supported. Accommodation is located over two floors in one adapted building. People had access to extensive well-maintained gardens.
People’s experience of using this service and what we found
Medicines were not always being managed in line with current best practice.
Systems of governance and oversight were not sufficiently robust to have identified the issues we found in relation to managing risks and the management of medicines.
Risk management was not always comprehensive and up to date. People who had been identified at risk did not always have documentation in place to guide staff.
Several people did not have current and up to date Deprivation of Liberty Safeguards in place. However, we were aware this had been applied for within the specified time to the local authority.
Records were not always completed correctly to document the support people were given.
People’s care plans did not always reflect their support needs. Some care plans had conflicting information recorded.
People were supported to follow their interests and take part in activities that were socially relevant to them. 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.
People had a choice of food and specific dietary requirements were catered for.
The management was aware of the culture of the service. We were aware there were ongoing issues relating to a member of staff. Where performance of staff was an issue this was dealt with accordingly. The service promoted and supported fairness and an open culture for staff to air their views and concerns.
Staff received safeguarding training when they first joined the service. Staff we spoke with told us they knew what abuse was and they would report any concerns following the correct procedure.
Staff were caring and respected people as individuals. Staff ensured people’s privacy and dignity needs were respected during personal care. People could be as independent as they wanted to be.
People and relatives spoke highly about the service and said Swarthmore was … “A great place to live” One person commented, “I am as happy as I would be anywhere.”
There was a wide range of activities for people to engage in and to follow their hobbies. The service encouraged people to take active roles in their community.
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 (published10 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance.
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.