Old Hospital Close (21)

Updated 20 August 2022

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

This inspection was carried out by one inspector.

Service and service type

Old Hospital Close (21) 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. Old Hospital Close (21) 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed the intelligence we held about the service including statutory notifications and feedback from others. We used all this information to plan our inspection.

During the inspection

We spoke with the newly appointed acting manager, the team leader, two staff members, the operations manager and one person using the service. We reviewed a range of documentation such as three people’s care files and medicines administration records. We also looked at quality assurance systems, staff files and meeting records. Following the inspection, we made contact with two relatives of people living at the home.

Updated 20 August 2022

About the service

Old Hospital Close (21) is a residential care home providing personal care to up to five people in one adapted building. The service provides support to those with a learning disability or autistic spectrum disorder, mental health, older people and those with dementia. At the time of our inspection the home was at full capacity.

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

Day to day management and oversight of the service needed some improvement, as the service had not had a registered manager for some time.

We identified issues with records management in that areas of update and improvement had not always been identified. This included updates to people’s risk assessments, staff supervisions, PRN ‘as required medicines protocols, submission of statutory notifications and staff recruitment files.

Care staff knew people well and had worked at the service for along period of time. We observed that people were comfortable with staff and interacted positively. People received their medicines when they needed them.

The premises were clean with regular infection control checks in place. Regular checks were in place to maintain the home. Where risks to people had been assessed steps were in place to support staff to reduce the likelihood of those risks occurring.

Staff received regular training and told us they felt well supported in their roles and that the management team around them were responsive. People were supported to eat meals of their choosing that met their dietary needs.

People were well supported and cared for, by staff that knew their individual needs and support requirements. Staff treated people with dignity and respect with care records reflecting their preferences.

People were supported to express their end of life wishes. Care records promoted independence and supported involvement in activities. There was a suitable complaints process.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: People were supported to be as independent as they could be in their care support and day-to-day activities.

Right care: People received personalised care, which reflected their choices and views. Care support was reviewed in line with people’s presenting needs. People accessed the local community.

Right culture: The culture of the home focused on the wellbeing of the people living there, with staff and management demonstrating an understanding of individual 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 28 August 2019)

Why we inspected

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Old Hospital Close (21) on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to good governance at this inspection.

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

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.