Archived: Queensgate Care Home

Queensgate Care Home is a care home that provides accommodation and personal care for a maximum of 40 older people, including people who may live with dementia. At the time of our inspection there were 28 people using the service.

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

Areas of the service required redecoration, refurbishment and maintenance. The décor looked tired. Whilst some areas within the service provided sensory and tactile stimulation, the main lounge and dining area was not decorated in line with dementia friendly guidance. The provider did not have a refurbishment and redecoration plan in place to identify and plan required works to the premises.

Not all staff received adequate supervision. The registered manager had not had a formal supervision for the duration of their employment. The provider did not have robust recruitment processes in place. We have made a recommendation about this in the inspection report.

Accidents and incidents were not effectively monitored to consider lessons learnt and reduce risks to people.

Quality assurance systems were not operated effectively and failed to ensure compliance with regulations. The registered manager and provider could not demonstrate satisfactory oversight of the safety and quality of the service because records were not always kept and maintained.

People told us they liked the staff and felt well cared for. People’s relatives felt their relatives were safe.

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.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 December 2018)

Why we inspected

We received concerns in relation to infection control and the premises. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this 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. This included checking the provider was meeting COVID-19 vaccination requirements.

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

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk.

Follow up

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 alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Throughout the pandemic the provider had worked to reduce the negative impacts of COVID-19 on residents. They had continued to deliver activities and events. Communication with families and friends had increased through the use of social media. For example, they shared videos and photographs of activities the resident has taken part in.

The service had increased their engagement with local community groups. For example, the home had received cards and pictures from a local school, and Christmas cards sent via a local supermarket.

The provider had recently developed an easy to read questionnaire for people living at the service to complete, to better understand their views and needs

Arrangements for visiting people were in place. These followed national guidance and minimised the risk of transmission of COVID-19 into the home.

Queensgate Care Home is a care home that provides accommodation and personal care for a maximum of 40 older people including people who may live with dementia. The home is registered for 40 people but as some of the bedrooms are no longer used as double occupancy bedrooms 34 people can be accommodated. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. Queensgate Care Home accommodated 29 people at the time of the inspection.

At our last inspection in May 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained good.

Staff were kind and caring and had developed good relationships with people using the service. People were comfortable in the presence of staff.

Staff received opportunities for training to meet peoples' care needs and in a safe way. A system was in place for staff to receive supervision and appraisal and there were robust recruitment processes being used when staff were employed.

There were enough staff available to provide individual care and support to each person. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff knew the needs of the people they supported to provide individual care and records reflected the care provided.

People were appropriately supported in maintaining their health and they received their medicines in a safe way. They were provided with opportunities to follow their interests and hobbies. People received a varied diet.

The building was well-maintained but improvements were required to hygiene in some areas of the home. The building had been designed to meet the needs of people living with dementia, in line with current research, and provided plenty of sensory and tactile stimulation. Areas were well-decorated with 'themes' to help people orientate around the home.

People had the opportunity to give their views about the service. There was consultation with staff and people and their views were used to improve the service. People said they knew how to complain. The provider undertook a range of audits to check on the quality of care provided.

Further information is in the detailed findings below.

This inspection took place on 13 April 2016 and was unannounced. The service was last inspected in July 2013 and was found to be compliant with the regulations inspected at that time.

At the time of the inspection 31 people were living at the service.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood the importance of protecting people who used the service from abuse. They could recognise the signs someone may display if they were being abused and knew how to report any abuse they may witness or become aware of to the proper authorities. Staff, who had been recruited safely, were provided in enough numbers to meet the needs of the people who used the service and keep them safe. Staff had been trained in how to administer people’s medicines safely. Systems were in pace to ensure people received their medicines on time, and as prescribed by their GP.

People who used the service were provided with a wholesome and nutritious diet which was of their choosing. Staff monitored people’s food and fluid intake and made referrals to dieticians and speech and language therapists when needed.

Staff had received training which was relevant to their role and equipped them to meet the needs of the people who used the service. People were supported make informed decisions by staff who had been trained in recognising and upholding their human rights.

People were supported to access health care professionals when needed and to lead a healthy lifestyle. People who were living with dementia were cared for in an environment which supported their needs and which assisted them to lead a fulfilling life.

People who used the service were supported by staff who were kind and caring and understood their needs. Staff were aware of the importance of respecting people’s dignity and upholding their right to freedom of choice. People or their representatives were involved in the formulation of care plans which described the person and their preferences. Reviews were held on a regular basis and these included all those who had an interest in the person’s welfare.

The service provided people who used the service with a range of in-house activities to choose from, and regular visits were undertaken to the surrounding community to use the local facilities. People were supported to pursue individual hobbies and interests and staff had access to documents which described the person and their preferences for care. The registered provider had an accessible complaints procedure which people, or other stakeholders, could use to raise any concerns. Complaints were investigated and resolved wherever possible to the complainants’ satisfaction.

The registered manager had systems in place which ensured the service was well-run and safe. People who used the service and other stakeholders were consulted about the running of the service. The registered manager welcomed suggestions and saw them as an opportunity to improve the service and changes were made as a result.

People lived in a well maintained, clean environment. One person said, 'The cleaner is marvellous she gives my room a really good clean.'

We found that people were protected from unsafe or unsuitable equipment because the provider had made sure that any equipment used was serviced and maintained regularly.

There were enough trained care staff on duty to meet people's needs. Care staff told us the training they received helped them to care for the people who used the service and meet their needs. They also told us they received good support from the management team.

We found that records were stored securely and demonstrated that people's needs were being met appropriately.

We found that people were provided with a varied and nutritional diet. People told us the food was excellent and they had plenty of choice. Comments included, 'The food is very good here and there's always plenty of it.'

We found that people's medication was administered and stored safely and staff had received medication training.

We found that staff had received training about meeting the needs of older people and how to keep people safe from harm.

We found that people could make complaints and these were acted on and resolved where possible to the person's satisfaction. People told us they would approach the manager or the care staff if they had any concerns.