The Care Quality Commission
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Court House Care Home

Overall: Good read more about inspection ratings

3-5 Court Road, Malvern, Worcestershire, WR14 3BU (01684) 572271

Provided and run by:
Court House (Malvern) Limited

Important: The provider of this service changed. See old profile

All Inspections

During an assessment under our new approach

Court House Care Home provides accommodation with nursing care for up to 60 people. Accommodation is arranged across 3 separate units which are designed to cater for the needs of people with similar requirements. At the time of this inspection there were 47 people using the service. This inspection was triggered by our need to review the action the provider had taken following enforcement action carried out following our last inspection. This was a comprehensive inspection, and we reviewed all the quality statements. At the last inspection the service was rated requires improvement. The service was previously in breach of the legal regulations in relation to safe care treatment and relating to good governance. Improvement was found at this inspection, and the provider was no longer in breach of these regulations. At this inspection the service has changed to good.

 

We found no concerns about the safety of care provided. Incidents and accidents had been reported, investigated and lessons learned shared with staff. Staff had the right skills and qualifications and were trained to carry out their roles. There were enough staff on duty to meet people’s needs. Medicines were managed safely. The provider carried out regular assurance visits. Action plans were produced and this meant there was additional oversight at provider level.

 

Staff assessed people’s needs face to face prior to moving to the service. Care plans and risk assessments were sometimes generic however, the management team were working with staff to address this and ensure all documentation was more person centred.

 

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. People with protected characteristics felt supported. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas. The provider had plans for ongoing redevelopment of the environment, and we saw evidence of work completed and in progress.

15 February 2023

During a routine inspection

About the service

Court House Care Home provides personal and nursing care for up to 60 people. The home is split into 3 units; 2 were for older people and 1 for younger adults. At the time of our inspection there were 57 people living at the home.

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

People's individual risks were not always comprehensively assessed to guide staff on how to keep people safe. People were not always protected from the risk of harm. An effective system was not in place for reporting and reviewing accidents, incidents and near misses involving people. People's medicines were not always safely managed, this meant people were at risk of receiving medicines which may not meet their current needs.

Care documentation was not consistently updated and some staff were not trained to meet people's specific healthcare needs. The provider did not have robust risk assessments and had failed to consistently identify environmental risks to people's safety and wellbeing.

People's person-centred needs weren't always at the forefront of their support. However, some people were supported with a range of meaningful activities and staff were attentive to people's emotional and social needs. Quality assurance systems were not always effective for people. This meant the action taken by the provider had not always ensured people received consistent, good quality and safe care. Systems were in place to seek feedback and resolve people's complaints.

The provider had not ensured all requirements under the Mental Capacity Act (MCA) and authorisations under the Deprivation of Liberty Safeguards were fully met. Not everyone was supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support good practice.

The provider had not always sent to us statutory notifications which is their legal responsibility to do so for notifiable incidents.

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 the service under the previous provider was good (published on 14 March 2020). This service was registered with us on 08 February 2022. This is the first inspection under this provider since their registration.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, medicines, infection control, and management oversight of the service. A decision was made for us to inspect and examine those risks.

This service had not been inspected since a change in registration; therefore, this inspection was also carried out to gain assurances about the quality of care and systems used to monitor and manage the service under the new provider.

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.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

Immediately following our visit, we sent the provider a letter asking them to respond to the immediate concerns we found at our visit. We continued to seek their updates and assurances they had mitigated the immediate risks to people.

We have identified breaches in relation to safe care and governance and management oversight of the service at this inspection. At this inspection we recognised that the provider had failed to submit statutory notifications to us in line with their regulatory responsibilities. Please see the action we have told the provider to take at the end of this report.

At this inspection we recognised that the provider had failed to submit statutory notifications to us in line with their regulatory responsibilities. This was a breach of regulations 16 and 18 of the Care Quality Commission (Registration) Regulations 2009.

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.