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Inspection Summary


Overall summary & rating

Good

Updated 14 November 2017

We inspected Quinton Gardens on 27 September 2017 and this inspection was unannounced. At the last inspection on 1 September 2015 the service was rated Good. At this inspection, the service continues to be rated Good, however we rated well led as requires improvement. This was because there was no registered manager in post, a rating poster was not displayed and people’s privacy was comprised by the use of CCTV because people and their relatives, had not been consulted with.

Quinton Gardens is divided into three separate floors and provides personal and nursing care for up to 35 people, including people living with dementia and physical disabilities. There were 35 people living at the home when we inspected the service.

A requirement of the service’s registration is that they have a registered manager. 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 and the associated Regulations about how the service is run. At the time of our inspection visit there was no registered manager in post. The registered manager had left the service on 15 September 2017. The provider had decided to take this role on themselves, and had applied to become the registered manager at the home.

Care and nursing staff received training in safeguarding adults and understood the correct procedure to follow if they had concerns. They were confident if they raised concerns with the managers and provider, these would be investigated.

People had been consulted about their end of life wishes. People’s care plans showed people’s wishes about who they wanted to be with them at this time and the medical interventions they had agreed to.

People received their medicines safely from care and nursing staff who were trained and assessed as competent. Medicines were stored safely and administered as prescribed, however, further support from pharmacists was needed when people’s medicines were given to them covertly.

People were supported to access healthcare from a range of professionals to help maintain their health and welfare.

The provider and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The management team had made applications to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA requirements. Decisions were made in people’s ‘best interests’ where they could not make specific decisions for themselves. However during our inspection visit we found the provider used CCTV to monitor people and visitors within communal areas of the home. There was no consultation with people regardless of their capacity, and we were told it was installed to limit the opportunity for some people to leave the home unnoticed. Following our inspection visit, the provider told us the system would not be used, until other areas had been explored and if then required, people would be consulted with and risk assessments put in place.

There were enough staff to care for people safely and effectively. All necessary employment checks had been completed before new staff started work at the home to make sure, as far as was possible, they were safe to work with the people who lived there.

People were supported by a consistent staff team that knew them well. Staff received training and had their practice observed to ensure they had the necessary skills to support people. Staff treated people with respect and dignity when providing their care and support. Staff promoted people to be as independent as possible.

People were supported to take part in social activities and pursue their interests and hobbies. People made choices about who visited

Inspection areas

Safe

Good

Updated 14 November 2017

The service remained Good.

Effective

Good

Updated 14 November 2017

The service remained Good.

Caring

Good

Updated 14 November 2017

The service remained Good.

Responsive

Good

Updated 14 November 2017

The service remained Good.

Well-led

Requires improvement

Updated 14 November 2017

The service was not always well led.

There was no registered manager in post and the provider had not displayed their rating which is their legal duty to do. The provider used CCTV inside the home but had not consulted with people and relatives to get their views on what they felt about this. Audit processes identified areas for improvement, but some improvements had not been identified fully, such as safe procedures for covert medicine administration.