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Archived: Regency Court Care Home Good

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Reports


Inspection carried out on 6 September 2016

During a routine inspection

This inspection took place on 6 and 7 September 2016 and was unannounced.

Regency Court Care Home provides both long term and respite nursing care and accommodation for up to 45 older people who also require nursing care. At the time of this inspection, there were 38 people living at the home.

The service was last inspected on 18 and 29 August 2015 when it was given an overall rating of ‘Requires Improvement.’ At that inspection we found breaches of four Regulations related to person-centred care, safe care and treatment, meeting nutrition and hydration needs and staffing. We required the provider to make improvements to achieve compliance with these regulations. The provider sent us an action plan which detailed the action they planned to take to make the improvements that were required. At this inspection we found that improvements had been made and legal requirements had been met. The overall rating of the service had improved.

A registered manager was in post when we visited. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The registered manager was present throughout the inspection.

The registered manager and staff understood their role in relation to the Mental Capacity Act 2005 (MCA) and how the Deprivation of Liberty Safeguards (DoLS) should be put into practice. These safeguards protect the rights of people by ensuring, if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect the person from harm.

Staff confirmed they had been trained in how to identify and report any incidents of abuse they may witness.

Any potential risks to individual people had been identified and appropriately managed. For example, people at risk of pressure wounds had received appropriate nursing care to reduce the risk of their occurrence or recurrence.

People’s medicines had been administered and managed safely.

There were sufficient numbers of staff on duty with the necessary skills and experience to meet people’s needs.

Staff supported people to eat and drink if required. They ensured people at potential risk received adequate nutrition and hydration.

People were provided with support to access health care services in order to meet their needs.

Positive, caring relationships had been developed with staff to ensure people received the support they needed. They were encouraged to express their views and to be actively involved in making decisions about the support they received to maintain the lifestyle they have chosen.

The culture of the service was open, transparent and supportive. People and their relatives were encouraged to express their views and make suggestions so they may be used by the provider to make improvements.

Inspection carried out on 18 and 19 August 2015

During a routine inspection

Regency Court Nursing Centre provides both long term and respite nursing care and accomodation for up to 45 older people, including people living with dementia. At the time of this inspection, there were 44 people living at the home, 43 of whom required nursing care.

A registered manager was in post when we visited. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

The majority of people and their relatives told us that they were happy with care they received. We heard staff speaking kindly to people and they were able to explain how they developed positive caring relationships with people. One person told us, “I am very pleased with the service. I am well looked after!” However, those people who were more dependant due to their needs were not receiving a consistently good service.

Staffing levels were insufficient to meet the needs of people who were nursed in bed or required staff support for their mobility.

People and their relatives said that the food at the home was good. Where necessary, people were given help to eat their meal safely and with dignity. There was insufficient evidence in care records to demonstrate that, where people were identified as being at risk of weight loss and malnutrition, there had been appropriate interventions to reduce the risk. People who were nursed in bed did not have access to fluids throughout the day to reduce their risk of dehydration.

A programme of activities had been provided for people to enjoy. However, it was not clear how they provided for the needs of people who stayed in their rooms. This meant that they were at risk of isolation and withdrawal.

Care plans did not include sufficient information about individual needs and preferences to ensure the care delivered was person centred.

Staff understood their role in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm. Staff confirmed they had received training in these areas. Where people did not have the capacity to make decisions for themselves, the registered manager acted in accordance with the Mental Capacity Act 2005(MCA). Where appropriate, DoLS applications had been made on behalf of people. Staff had been provided with appropriate training to ensure they were able to deliver care to people with complex needs.

A quality assurance system was in place to monitor how the service had been provided and to identify shortfalls. However, it was not sufficiently robust to identify the concerns we found at this inspection. We have recommended the provider reviews its governance and auditing systems.

People and their relatives said that they felt safe, free from harm and would speak to staff if they were worried or unhappy about anything. They told us that the manager was approachable. Staff knew how to identify the signs of possible abuse, and knew how to report any allegations of bullying or abuse.

We have identified several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told this provider to take at the back of this report.

Inspection carried out on 29 August 2013

During a routine inspection

We spoke with six people living at the home.. All were satisfied with the care and support they received and were happy living there. One person told us, "The care here is A1. I can't fault it". Another said, "I've been in three or four care homes and this is the best by far". We also spoke with a visitor who told us, "My relative is very happy here and I'm always treated very well". The home employed a full-time activities co-ordinator; the people we spoke with were happy with the extensive range of activities on offer.

We spoke with the home manager and five members of staff. They all told us that they were happy working at Regency Court and were treated as respected team members. One staff member said, "I wouldn't have been here for so many years if I didn't like it!" Another told us, "We work as a team and make sure everybody is looked after properly".

Inspection carried out on 22 March 2013

During a routine inspection

We were informed that there were thirty nine people living at the Regency Court Nursing Centre. We looked around the building which was clean and free of unpleasant odours. All the rooms were single occupancy with their own toilet and hand basin. The rooms were personalised with photographs, TV’s and pictures and some people had their own furnishings. There was a lift so people could access the first and second floors.

During our visit we spoke with three people who used the service and four members of staff including the registered manager, a health care professional and a visitor. We spent time observing how staff interacted and supported people. We saw staff treating people in a sensitive, respectful and professional manner.

All the people we saw looked happy living at the Regency Court Nursing Centre. People told us that that they liked living here, and that the staff were very good, another person told us that they were ‘quite happy’. A visitor we spoke with told us that all the staff were pleasant, they kept the family informed and their relative was well looked after.

We saw that care plans were person centre and people’s care assessments looked at people's goals and the support they required. Care plans had details of people’s likes and dislikes. One person informed us that staff would always ask them what they wanted for example they would select clothes and show them so they could chose.

During an inspection to make sure that the improvements required had been made

We did not, on this occasion, visit this service so cannot report what the people using this service said.

Inspection carried out on 6 September 2011

During an inspection in response to concerns

We spoke to five members of staff who were on duty. This included three care assistants and two trained nurses. They told us about the level of care they provide to identified people at Regency Court Nursing Centre. They told us about the support they have received to enable them to provide good quality care. They also told us about their roles and responsibilities with regard to identifying and reporting incidents or allegations of abuse

We spoke to the manager about the systems that were in place to assess, review and plan care provision to meet the needs of each person accommodated. We also spoke to the manager about how incidents or allegations of abuse and how they are managed.

We were visiting at this time as a result of information we had received with regard to the reporting and management of incidents and allegations of abuse.

Reports under our old system of regulation (including those from before CQC was created)