Prema Court

Updated 17 April 2021

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.

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 two inspectors.

Service and service type

Prema Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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. Inspection activity started on 16 March 2021 when we visited Prema Court and ended on 23 March 2021.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. 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. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, nurse, support workers and domestic staff. We observed staff interacting with people throughout the inspection.

We reviewed a range of records. This included three people’s care records and multiple medication records. A variety of records relating to the management of the service, including quality assurance systems, policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training, supervision and quality assurance records. We contacted three professionals who regularly visit the service.

Updated 17 April 2021

About the service

Prema Court is a residential care home providing personal and nursing care to 29 people with mental health needs at the time of the inspection. The service can support up to 44 people.

Prema Court comprises of two buildings, Brook House and Clifton House. Each person has their own bedroom, with shared lounge and bathroom facilities. Small kitchens are available in each building for people to use as well as a central kitchen and dining room. At the time of our inspection Brook House was being re-furbished, so all the people living at Prema Court were living in Clifton House.

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

A recovery model was being embedded at Prema Court to support people with their mental health. Nurses and care support staff were engaged with people to involve them in their care and support and work towards achievable goals and aspirations.

People’s care and support needs were assessed. Care plans and risk assessments were regularly reviewed and were up to date. Action was being taken to reduce the risk of people leaving Prema Court unaccompanied when they should have staff support. All incidents were recorded and reviewed to identify actions to reduce further occurrences.

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 received their medicines as prescribed, with the service now using paper-based medicines administration records. The service worked closely with the GP surgery and pharmacist. There were enough staff on duty to meet people’s needs, Staff were safely recruited.

A quality assurance system was in place, with regular audits being completed and action plans written for any shortfalls identified. The area manager had oversight of the service through an electronic recording system and monthly audits.

Infection control procedures were in place and staff used PPE effectively. Additional cleaning had been introduced during the COVID-19 pandemic. A visitors pod had been built to enable relatives to visit safely.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 June 2019) and there were four breaches of regulations.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 30 April 2019. Four breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, person-centred care, good governance and the notification of incidents to the CQC. We had also received concerns in relation to the management of risks, including people leaving Prema Court unaccompanied when they should have staff support, people not returning to the home after going out and the management of behaviours.

As a result, we undertook this focused inspection to review the concerns, check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, responsive and well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection. We found no evidence during this inspection that people were at risk of harm from the concerns that had been raised with us. Please see the safe, responsive and well-led sections of this full report. Action had been taken to reduce the risk of people leaving the home unaccompanied or not returning to the home after going out.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.