Background to this inspection
Updated
9 April 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This was a comprehensive inspection.
The inspection took place on 27 February, 1 and 4 March 2019. The first day was unannounced. The inspection was carried out by an adult social care inspector, a medicines inspector 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.
Before the inspection we reviewed the information we held about the service, including previous inspection reports, safeguarding concerns and notifications we had received from the service. A notification is information about important events which the provider is required to send us by law. We contacted Healthwatch Lancashire for feedback about the service. Healthwatch Lancashire is an independent organisation which ensures that people’s views and experiences are heard by those who run, plan and regulate health and social care services in Lancashire.
During the inspection, we spoke with five people who lived at the service and four relatives. We also spoke with four care staff, two nurses, the registered manager, the service provider and two visiting health care professionals. We looked in detail at the care records of two people who lived at the service. In addition, we looked at service records including staff recruitment, supervision and training records, policies and procedures, complaints and compliments records, audits of quality and safety, fire safety and environmental health records. Following the inspection we contacted one relative and five people’s independent advocates for feedback about the care provided at the home.
As a result of concerns about standards of care at the home, in August 2018, the service became subject to Lancashire County Council and East Lancashire Commissioning Group’s Quality Performance and Improvement Planning (QPIP) process. As a part of this process, documentation and practices at the home were reviewed and discussed during regular meetings involving a variety of stakeholders, including CQC. This process was instigated to ensure that the service provider achieved the improvements necessary for people living at the home to receive safe and effective care.
Updated
9 April 2019
We carried out a comprehensive inspection of Church View (Nursing Home) on 27 February, 1 and 4 March 2019. The first day was unannounced.
Church View (Nursing Home) is registered to provide nursing and personal care for up to 40 older people, younger adults and people living with dementia. There is a separate unit for people living with dementia, which has it's own lounge and dining area. Accommodation is provided on the ground floor. There are gardens and a car park for visitors and staff. The home is situated in a quiet residential area in Accrington, close to local amenities. At the time of our inspection there were 20 people living at the home.
The service 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 we looked at both during this inspection.
At the time of the inspection, there was a registered manager in place who was responsible for the day to day running of the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how to service is run.
At the last inspection on 19 and 22 June 2018, we found a breach of the regulations relating to a failure to provide people with safe care and treatment. Following our inspection, the provider sent us an action plan and told us that all actions would be completed by 30 September 2018. We also found a breach of the regulations relating to the provider’s failure to have oversight of the service and to assess, monitor and improve the quality and safety of the service. We issued a warning notice and required the provider to be compliant by 10 September 2019.
At this inspection we found that many improvements had been made and all of the regulations reviewed were being met. However, many improvements were in the early stages and it is necessary for the provider to provide evidence that the improvements made are being sustained over time.
People told us they were happy with staffing levels at the home and never waited long when they needed support.
We found evidence that people’s medicines were administered safely and people told us they received their medicines when they should. Some minor improvements were needed to some medicines practices. Records showed that the registered manager had identified the improvements that were needed during recent audits and was in the process of introducing the necessary changes.
Staff had been recruited safely and the staff we spoke with understood how to protect people from abuse or the risk of abuse.
People received appropriate support with their nutrition, hydration and healthcare needs. Referrals were made to community healthcare professionals to ensure that people received appropriate support.
We found that people were supported and encouraged to take part in a variety of activities and some people were supported to go out. People told us they were happy with the activities and entertainment provided at the home.
Staff received an effective induction and appropriate training. People felt that staff had the knowledge and skills to meet their needs.
People told us they liked the staff who supported them and that staff were caring and respected their right to privacy and dignity. We observed staff encouraging people to be independent when it was safe to do so.
Staff communicated effectively with people. People’s communication needs were identified and appropriate support was provided. Staff supported people sensitively and did not rush them when providing care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. Where people lacked the capacity to make decisions about their care, the service had taken appropriate action in line with the Mental Capacity Act 2005.
People told us that they received care that reflected their needs and preferences and we saw evidence of this. Staff told us they knew people well and gave examples of people’s routines and how they liked to be supported.
The registered manager sought feedback from people living at the home about the support they received. We saw evidence that she used the feedback received to develop and improve the service.
People living at the service and relatives were happy with how the service was being managed. They found the registered manager and staff approachable and helpful.
A variety of audits and checks were completed regularly by the registered manager. We found that the audits completed were effective in ensuring that appropriate levels of quality and safety were being maintained at the home. We found that the provider had oversight of the service. He received regular reports from the registered manager and they met regularly to discuss the service, including any concerns. This meant that the provider could be assured that people were receiving safe care which met their needs.