Quinton Gardens

Quinton Gardens is a care home providing accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury care for up to 35 people. The service provides support to younger and older people, who may live with dementia, physical disabilities, sensory impairment or mental health needs. At the time of our inspection there were 33 people using the service.

People’s experience of the service and what we found:

We found no evidence of harm to people, but risks to some people could be further reduced. These included risks in relation to the premises and how people’s safety needs were managed. We identified some items of equipment required replacing to reduce risks to people further. Action was taken to address this. The provider took immediate action to start to address these. Staff know how to protect people from abuse and staff were recruited safely there were enough staff to care for people.

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.

People were supported to have the medicines they needed to remain well. Systems were in place to take learning, should anything go wrong with people's care. Staff were supported to maintain good infection control through training and supplies of PPE.

There had been significant changes to the leadership at the home and the checks the provider is making so they can be assured people are receiving good care, and that areas of improvement are promptly identified and actions addressed. There was an open culture at the home which encouraged people, relatives, and staff to make suggestions to improve people's care further. Staff had developed good working relationships with other health and social care professionals, which promoted people's well-being. People were achieving good outcomes, such as desired increase in weight, and people were now less anxious.

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

Rating at last inspection

The last rating for this service was Good, published 14 November 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remain good based on the findings of this inspection.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Quinton Gardens on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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 them at the home, which helped people maintain personal relationships with people that were important to them.

Complaints received were investigated and analysed so that the provider could learn from them. People who used the service and their relatives were given the opportunity to share their views about how the service was run and action was taken in response.

Systems of audits and checks required further improvement to ensure the provider met their regulatory responsibilities. For example, a ratings poster was not displayed within the home and we found completed medicines audits had not identified the issue we found regarding covert medicines. Following this inspection visit, the provider confirmed the rating poster was now displayed and action had been taken to ensure covert medicines were given safely and as directed.

The management team worked well together and were committed to providing a high quality service to people. The provider had a clear vision for the development of the service and demonstrated a commitment to implement best practice and improved technology to drive improvements. The provider and staff were passionate about delivering a good service and were working towards providing an outstanding service within this and the providers other home, located next door.

Before they left the service, the registered manager had submitted a Provider Information return (PIR) to us and they and the provider understood their legal responsibility to notify of us of important and serious incidents.

Further information is in the detailed findings below.