Background to this inspection
Updated
5 April 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
Two inspectors.
Service and service type:
Victoria House 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 provides personal care and accommodation for six people living with a learning disability.
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:
Unannounced.
What we did:
Before the inspection we reviewed the information, we held about the service and the service provider. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.
We spoke with the local authority commissioners and other health and social care providers to gather feedback.
Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. This is known as a Provider Information Return (PIR). The provider had completed a PIR.
During the inspection it was not always possible to speak to everyone and ask direct questions about the service they received because of people’s learning disabilities. However, people could express how they felt about where they were, the care they received and the staff who supported them through non-verbal communication. We observed interactions between staff and all the people using the service as we wanted to see if the service communicated and supported people in a way that had a positive effect on their wellbeing.
We spoke to four members of staff and reviewed four people's personal care records, one staff record, staff duty rotas, medicine administration records and other records relating to the management of the service such as health and safety and training records.
After the inspection we spoke with three relatives of people living at the service over the phone, and received documents to review including quality assurance and feedback records.
Updated
5 April 2019
About the service:
Victoria House is a residential care service providing personal care and accommodation for up to six people living with a learning disability. At the time of our inspection six people were using the service.
People’s experience of using this service:
• The service was not always clean. We recommended the service ensure there were systems in place to prevent the risk of infection.
• The service did not record and learn from accidents and incidents. We recommended the service follow best practice guidance and demonstrate a culture of continuous improvement.
• People's risks were not always assessed to ensure staff could provide adequate care and support. We recommended the service assessed people’s risks to ensure risks was mitigated.
• People were protected from potential harm and abuse.
• There were enough staff to provide support and staff had been recruited in a safe manner.
• People received their medicines in a safe way.
• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did not support this practice. We recommended the service review their systems to manage this in line with best practice.
• The service was adapted to meet the needs of people living in the service.
• The service supported people to maintain a healthy lifestyle and access support from other health and social care professionals.
• Staff were provided with adequate training and support to provide effective care.
• People received support that was caring and met their needs.
• People were supported to be independent and their privacy and dignity was respected.
• People and their relatives were involved in their care package and knew how to raise a complaint.
• The quality assurance systems in place did not identify the shortfalls we found during our inspection. This demonstrated a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, ‘Good Governance.’
• People and their relatives spoke positively about the registered manager and the service worked well in partnership with others to improve the quality of care provided.
Rating at last inspection:
At the last inspection the service was rated Good, (published: 1 September 2016).
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Enforcement:
Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up:
We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk