21 July 2021
During an inspection looking at part of the service
Service to the Aged (known as Sage) is a residential care home providing nursing and personal care to older people of the Jewish faith. The home is registered to accommodate 60 people. At the time of the inspection there were 39 people living in the home.
The home is purpose built consisting of three separate floors with their own lounges, kitchenettes and bathrooms. In addition the home has a number of communal rooms on the ground floor for dining, activities and visitors. One floor specialises in caring for people who live with dementia and two floors accommodate people with nursing needs. There is always a nurse in charge of each of the three floors.
People’s experience of using this service and what we found
Risks to people’s safety and wellbeing had been assessed and action taken to help keep people safe from harm, however we found some risks relating to catheter care and dysphagia. Medicines were managed and administered safely. People experienced good care and treatment.
The home followed appropriate procedures for reporting any accidents or safeguarding concerns. Incidents and accidents were reflected on to see if any improvements were needed.
There were enough staff deployed to meet people's needs and ensure their safety. The home’s recruitment procedure was not always followed properly in checking applicants’ conduct in previous employment. We made a recommendation to improve recruitment practice.
People living in the home and their relatives told us they enjoyed living at this home and felt their religious and cultural needs as Jewish people were met well. The food, activities and daily and weekly routines met their requirements. They told us they were happy with the care and support they received. 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.
Staff received training for their roles. Staff were caring and kind in their interactions with people and asked their consent during daily tasks. Staff knew people’s needs well. Staff supported people to meet their health and nutritional needs.
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 23 November 2019) . At this inspection the rating has deteriorated to requires improvement.
Why we inspected
The inspection was prompted in part by notifications of three specific incidents. Two of the incidents had been investigated by the local authority and one was being investigated at the time of the inspection. As a result, this inspection did not examine the circumstances of the incidents.
The information CQC received about the incidents indicated concerns about the management of catheters, dysphagia and communication between staff employed at the home and externally employed care workers. This inspection examined those risks. We undertook a focused inspection to review the key questions of safe, effective 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.
We have found evidence that the provider needs to make some improvements.
Enforcement
We found a breach of regulations relating to safe care and treatment (managing risks). You can see what action we have asked the provider to take at the end of this full report.
The provider acted immediately to try to mitigate the risks to ensure people would receive safe care and treatment.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.