Archived: Queens Oak Care Home

Updated 23 November 2022

Inspection team

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.

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, a pharmacy inspector and a specialist professional advisor.

The specialist professional advisor worked as a nurse consultant in practice improvement and dementia care.

Service and service type

Queens Oak Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

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 Care Quality Commission 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 not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we held about the service. This included notifications of serious incidents the provider is required to tell us about and complaints we had received about the service. We used the information the provider sent us in the provider information return. 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 of this information to plan our inspection.

During the inspection

Inspection activity took place on 29 September 2022. We looked at records of care and support for six people and records of medicines management for 12 people and records of recruitment and induction for 5 staff members. We spoke with 2 nurses, a clinical lead, the interim manager and the director of quality. We spoke with 8people who used the service and 14 friends or family members and made observations of people’s interactions with staff, mealtimes and activities.

After the inspection

We continued to review evidence we had collected and additional evidence that we had requested from the provider.

Updated 23 November 2022

About the service

Queens Oak Care Home is a residential care home providing personal and nursing care to up to 89 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 67 people using the service.

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

People told us they were treated with kindness and care by staff. People knew how to complain and felt they were listened to, however we found examples of where issues had not been promptly addressed by the service. The service engaged with people and their family members considering their equality characteristics and kept people informed of changes to the service.

Some key areas of safety were not always effectively managed. Risks to people were assessed but sometimes risk management plans were not followed. We found examples of skin integrity issues not being fully addressed. Medicines were not always managed safely at the home.

The service had a new manager who recognised where improvements were needed. Quality and audit systems were in place but did not always fully identify areas which were not working well. People were safeguarded from abuse and improper treatment and there were suitable measures to protect people from infection risks, including those from Covid-19.

Staff spoke of being well supported by managers and were able to develop their skills. Staff were recruited in line with safer recruitment measures and the service had worked to recruit care workers and nurses from overseas and support them to obtain appropriate qualifications.

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.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 30 December 2020).

Why we inspected

We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have found breaches in relation to safe care and treatment at this inspection.

Follow up

Following our inspection the provider informed us of their intention to close the service. We will request an action plan and meet with the provider to understand what they will do to improve the standards of quality and safety in the meantime. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service.