Archived: Swan House Care Home

We found the following examples of good practice.

Staff and visitors were required to have their temperature checked, sanitise their hands and wear full personal protective equipment (PPE). Staff took part in the providers testing programme. Visitors to the home were required to take a COVID-19 test and wait for the result before entering the home.

The provider supported families and friends to visit the home, these needed to be booked and were carried out in a designated area that was safe for this purpose, and completely sanitised after each visit. Regular audits were in place to monitor infection control practices.

Individual risk assessments were completed to keep people and staff safe. Staff wore PPE and followed the appropriate guidance. Daily visual checks were completed to ensure best practice was followed.

The building looked clean and free from clutter and appropriate cleaning products were used to ensure good infection control was maintained. All frequently touched areas, such as door handles, were sanitised every two hours.

There was good communication for staff and people about any relevant changes. A designated COVID-19 folder was kept in the staff room for easy access to guidance. Social distancing, zoning and cohorting of staff were in place. Staff breaks were also staggered to ensure social distancing was maintained in the staff room.

People’s experience of using this service:

Staff understood the risks to people and measures were in place to keep them safe. Systems were in place to manage people's medicines safely and to reduce the risks associated with the spread of infection.

Recruitment processes were followed to ensure staff were of good character and suitable to work at the service. Sufficient numbers of staff were employed to meet people's needs. Staff received training that gave them the necessary skills and knowledge to carry out their roles and meet the specific needs of people using the service.

People were provided with the care, support and equipment they needed to stay independent. Staff were kind and caring and had developed good relationships with people using the service.

People were supported to maintain their health and had access to a varied choice food and drink. People had access to a wide range of activities in the community and within the service, that reflected their specific needs and interests.

People's communication needs had been assessed and were meeting the requirements of the Accessible Information Standards. This set of standards sets out the specific approach for providers of health and social care to identify, record, share and meet the communication needs of people with a disability, impairment or sensory loss.

People's privacy, dignity and rights were respected and upheld. People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible.

There were clear and effective systems in place to identify and manage risks to the service and drive improvement. There was an open culture of learning from mistakes, concerns, incidents and accidents. The manager and staff worked well with other agencies to ensure people received high quality joined up care.

Rating at last inspection:

Good (report published 18 August 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remains Good.

Follow up:

We will continue to monitor all intelligence received about the service to ensure the next inspection is scheduled accordingly.

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

This unannounced inspection took place on 25 July 2016.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were knowledgeable about recognising, reporting and the recording procedures to help protect people from any, or potential, incident of harm. A sufficient number of qualified, competent and safely recruited staff were in post to meet people’s assessed needs

People’s medicines were safely administered, stored and disposed of. However, protocols for some people’s 'as and when required' medicines were not in place, not correct or out of date. This meant that staff had a lack of up-to-date guidance to manage people’s conditions, such as pain, by means of prescribed medicines.

Staff were regularly trained and assessed as being competent to safely administer people’s prescribed medicines. An effective induction, supervision and mentoring process was in place to support staff in their role.

Risk assessments and risk management strategies were in place to help ensure that people were not exposed to unnecessary risks to their health. Risk assessment reviews were completed according to each person’s needs. Systems were in place to support people in the event of an emergency such as a fire.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The registered manager, nursing, senior and care staff were knowledgeable about when an assessment of people’s mental capacity was required. Appropriate applications had been made by the registered manager to lawfully deprive of their liberty as well as people being cared for in the least restrictive manner. Authorised and renewed DoLS were adhered to. This meant that, where appropriate, people were being lawfully deprived of their liberty.

People were supported to access a range of health care services and their individual health needs were met. People’s nutritional support needs were met and people had access to refreshments and snacks. This included the provision and choice of appropriate or foods and drinks diets for those people at an increased risk of malnutrition, dehydration or weight loss.

People’s care was provided by staff who undertook this role with respect, dignity and compassion. People, or their authorised representative, were involved in the planning and delivery of their care. Information was made available for people or their relatives who may have needed an advocate or requirement to access independent advocacy.

People were given various opportunities to help identify and make key changes or suggestions about any aspects of their care. A complaints procedure was in place and actions were taken to help prevent the potential for any further complaints.

A range of audit and quality assurance procedures were in place. This was to help identify what worked well and any area that required improvement. However, these audits were not always as effective as they could have been. People, staff and visitors were encouraged to provide their feedback and views on the quality of care people received.

Care planning and the delivery of care were seen to meet people needs. Staff demonstrated they knew how to meet people's individual needs.

Medication was being managed in a safe and appropriately recorded manner which had ensured that people had received their medication safely and as prescribed.

We found that there were enough care staff to meet people's needs, although people's mealtime needs were sometimes difficult for staff to manage.

The report shows that two managers are registered for this location. This is because we have not received an application to cancel the registration from one of the registered managers.

The home had a suitable and easily accessible complaints process.