Regent Hotel

Updated 14 October 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.

Inspection team

The inspection was completed by 2 inspectors and an Expert by Experience who made calls to people’s relatives. 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

Regent Hotel is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Regent Hotel is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

Notice of inspection

This inspection was unannounced. Inspection activity started on 18 July 2023 and ended on 2 August 2023. We visited the location’s service on 18 and 25 July 2023.

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 contracts and safeguarding teams. We used the information the provider sent us in the provider information return (PIR). 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 this information to plan our inspection.

During the inspection

We spoke with 9 members of staff including care staff, senior staff, and the deputy manager. We also spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 5 people who used the service and 5 relatives. We observed staff interactions and 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 looked around the service to review the facilities available for people and the infection prevention and control procedures in place. We also looked at a range of documentation including care files, and daily records for 6 people and medication administration records for 7 people. We looked at 2 staff recruitment files and reviewed documentation relating to the management and running of the service such as staff rotas, training and audits.

Updated 14 October 2023

About the service

Regent Hotel is a care home providing personal care and accommodation to 19 older people who may be living with dementia at the time of our inspection. The service can support up to 29 people across three floors and has lift access and bathroom facilities located on each floor.

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

People at Regent Hotel did not receive safe, quality care. People’s medicines were not always administered safely and as prescribed. Equipment used to help people transfer was not safe and appropriately maintained. Risks to people’s health, safety and wellbeing were not always identified, assessed and appropriately managed. Furthermore, guidance from safeguarding teams was not always followed. Areas of the service were not clean and there were unpleasant odours.

Staff were not recruited safely and the risk of staff working without references had not been assessed and mitigated. Staffing levels were low, which meant people’s needs were not always met in a timely manner. People who were at risk of falling did not always receive appropriate supervision. Not all staff had completed required training and did not receive appropriate supervision to ensure they were properly supported and had the required skills for their roles.

People were not supported to have maximum choice and control of their lives and staff 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.

Referrals had not always been made to relevant healthcare professionals when people needed them and guidance from health professionals was not always followed. Mealtimes were a poor experience for people, as there was a lack of meal options, people were not informed what they were eating, and people were not offered the opportunity to eat at the dining table.

The provider and the registered manager continued to fail to maintain the safety of the service and improve the quality of care delivered. Shortfalls had not been identified and this included with medicines, risk management, equipment and premises safety, people’s personal hygiene, mealtime experiences, healthcare referrals, recruitment records and staff training.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 February 2023). This service has been rated requires improvement for the last two consecutive inspections and has been rated inadequate at this inspection. At this inspection we found the provider remained in breach of regulations and new breaches of regulations were also found.

At our last inspection we recommended the provider reviewed and analysed questionnaire responses and take action to implement people’s and staff’s views. The provider had not acted on the recommendation and had not made improvements.

Why we inspected

We received concerns in relation to medicine errors, staff training, staffing levels, neglect, behavioural needs of people, lack of food and fluids and falsified records. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We have found evidence that the provider needs to make significant improvements. Please see the safe, effective, and well-led sections of this full report. The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Regent Hotel on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines, risk management, infection prevention and control, mental capacity, staff training, staffing levels, staff recruitment, person-centred care and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.’ This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.