Archived: Portland Nursing Home

Updated 1 June 2023

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 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

The inspection was carried out by 3 inspectors 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

Portland Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

Registered Manager

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. 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.

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at notifications sent to us by the provider. A notification is information about important events which the provider is required to tell us about by law. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

Inspection activity started on 04 April 2023 and ended on 25 April 2023. We visited the service location on 04 April 2023. We spoke with 4 people that used the service and 11 relatives about their experience of the care provided. We spoke with 7 members of staff including a registered manager, deputy manager, nurses and care workers.

We reviewed a range of records. This included care records for 5 people and multiple medication records. We looked at 2 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 also reviewed.

Updated 1 June 2023

About the service

Portland Nursing Home is a residential care home providing personal care to up to 40 people. The service provides support to older people with a range of health conditions. At the time of our inspection there were 24 people using the service. The accommodation is across three floors, with communal areas on the ground floor.

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

Call bells were not responded to in a timely manner as the system was not maintained by the provider. Medicines were not safely managed as temperatures were not routinely monitored, protocols were not in place for as required medicines and medicine records were not always clearly written or fully completed.

People were not always protected from the risk of abuse as incidents were not always reported. Fire safety risks had not always been assessed or actions taken to mitigate. Infection control in the laundry needed to be reviewed as it was unsafe.

Meals were not always well presented, and people were not always offered alternative options. Practice fire evacuations had not been completed regularly, storage was limited and impacted on accessibility to a bathroom. Two people were sharing a room and a solution had not been found to ensure this did not impact on relatives visiting.

People’s privacy and dignity were not always respected, and people were subjected to institutionalised practice. Bathing routines and other care needs were displayed in a communal area. We found a person sitting in a wheelchair without foot plates.

The complaints procedure was not clear, and records of complaints were not maintained. The provider had no analysis of complaints. People had complained and this had not been recorded. Relatives were not clear on complaints procedure, and one was worried about complaining. People were not engaged in activities and people spent most of their time in their rooms. People’s communication needs were not always fully considered.

Governance and quality assurance systems were ineffective, and the provider had failed to monitor and identify areas of improvement needed. There was no engagement with people or relatives to improve the outcomes for people.

People were not always supported to have maximum choice and control of their lives and did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 28 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement

We have found breaches in relation to medicines management, the provider’s quality assurance systems, person centred care and handling of complaints. Please see the action we have told the provider to take at the end of the full version of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.