Halton View Care Home

Updated 10 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and a medicines inspector.

Service and service type

Halton View Care Home is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Halton View Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was no registered manager in post. A new manager for the service had very recently commenced employment.

Notice of inspection

This inspection was unannounced on all three days.

What we did before the inspection We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people who used the service and two family members about their experience of the care provided. We also observed interactions between staff and people who used the service. We spoke with 10 members of staff, including the manager, representatives of the provider, care workers and maintenance and administration staff. We reviewed a range of records. This included people's care records and medication records. We looked at a selection of staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 10 October 2023

About the service

Halton View Care Home provides accommodation for persons who require personal care. The home provides support to older people including those living with dementia and can accommodate up to 64 people. The ground floor provides accommodation for people who require general residential care, and the first floor accommodates people who are living with dementia. At the time of our inspection there were 45 people living at the home.

People’s experience of using this service and what we found

Systems in place to protect people from harm and learn lessons when things went wrong were not always effectively used and therefore failed protect people from abuse or improper treatment. This exposed people living at the home to a risk of harm.

People were exposed to a risk of harm as their care needs and associated risks had not been routinely assessed, reviewed, monitored, or mitigated. Medicines were not managed safely.

Staff were not always deployed effectively to ensure people's safety or that their needs were met in a timely way.

Ineffective governance and quality assurance measures meant that people were exposed to unnecessary risk. Monitoring systems failed to identify and address shortfalls found during this and the previous inspection. This was in relation to risk and medicines management, accurate care planning and recording, governance and the oversight and deployment of staff. Furthermore, improvements were needed to cleaning regimes throughout the service.

People were supported by staff who knew them well and it was evident that positive relationships had been formed.

The newly recruited manager was aware of their role and was in the process of developing an action plan to make positive changes to the service provided for people.

We could not be assured that 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; or that the policies and systems in the service supported this practice. At the time of this inspection the newly recruited manager was carrying out a full review of Deprivation of Liberty Safeguards (DoLS) and best interest decisions that were in place for people using the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 October 2023).

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive, and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Halton View Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, management of risk, the environment, safeguarding and management oversight. We have made a recommendation in relation to staffing.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.’ This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.