Archived: Prestige Nursing Swindon

Updated 23 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We undertook a focused inspection of Prestige Nursing Swindon on the 7 April 2016. This inspection was completed to ensure improvements to meet legal requirements planned by the provider after our comprehensive inspection on the 13 October 2015 had been completed. We inspected the service against four of the five questions we ask about the services: is the service safe, effective, responsive and well led. This was because the service was not meeting legal requirements in relation to these questions and we had issued requirement notices following the comprehensive inspection.

The inspection was carried out by one inspector. Before our inspection we reviewed the information we held about the service. This included the provider's action plan, which set out the action they would take to meet the legal requirements.

During our inspection we spoke with three people who used the service, one relative, the manager, the regional manager, the quality compliance manager and six staff members. We reviewed a range of records which included quality monitoring documents, medicine administration records, four people’s care plans and four staff files.

Updated 23 June 2016

At the comprehensive inspection at this service in October 2015 we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued the provider with three requirement notices stating that they must take action to address these breaches.

This focused inspection was carried out to assess whether the provider had taken the necessary actions to meet the three requirement notices we had issued. We will carry out a further unannounced comprehensive inspection to assess whether the actions taken in relation to the requirement notices have been sustained, and to provide an overall quality rating for the service.

This report covers our findings in relation to the requirement notices we issued and we have not changed the ratings since the inspection in October 2015. The overall rating for this service is 'Requires improvement'. You can read the report from our last comprehensive inspection by selecting 'all reports' links for Prestige Nursing Swindon on our website at www.cqc.org.uk.

At this inspection we found the provider had taken some action to address the issues highlighted in the requirement notices but further improvements still needed to be made. The manager had developed an action plan to address the requirement notices in the inspection report where they were found to be in breach of regulations.

At our last inspection we found that medicines were not being managed safely or recorded appropriately. At this inspection we saw staff had received medicine update training. The manager had created a new medicine administration record to make the process clearer for staff and there were clear procedures in place for dealing with any medicine errors. We saw one person’s medicine administration record (MAR) did have some missed signatures and did not record the date accurately.

Previously at our last inspection staffing levels had been inconsistent resulting in some missed visits for people. During this inspection people and staff told us they had seen improvements. The manager had significantly reduced the high sickness levels by ensuring staff were aware of the formal process to take when calling in sick and was holding the back to work interviews when staff returned.

Our last inspection showed that staff had not been receiving regular supervision to appropriately support their role. At this inspection we saw that supervisions were now consistent and a performance development plan was going to be put in place alongside observational supervisions for staff.

Health care assessments and monitoring charts were still not being appropriately completed or followed correctly to meet people’s needs effectively. This was a breach of the Regulations.

At our last inspection care plans had not contained up to date information, required for staff to be able to care for people consistently. People had not been receiving regular reviews of their care needs. At this inspection we saw that some progress had been made in relation to providing guidance for staff on specific health needs but more improvements were needed. We saw that people were now having their care needs reviewed and families were being involved in these reviews.

The service did not have a registered manager in place. The branch manager has been responsible for the day to day running of the service and had put in an application to register with us but this was rejected for incorrect completion. Not having a registered manager at this location is a breach of the providers conditions of registration and further action will be taken if this is not addressed.

At our last inspection the manager did not have effective systems in place to monitor the quality of the service. At this inspection we looked at the manager’s online compliance system and saw audits of the service were being completed. The service had also received support from its internal quality compliance team.

We saw at this inspection the ratings from our last inspection were not clearly displayed at the service location. This is a breach of the Regulations and we have told the provider to take action in line with this regulation.