- Care home
Palace House Care Home with Nursing
Assessment report published 22 April 2025
Contents
Ratings
Our view of the service
Palace House Care Home with Nursing is a residential care home which provides personal care and nursing care for up to 33 older people, younger adults, people with a physical disability, sensory impairment, and people living with a dementia. We assessed all quality statements under the five key questions of Safe, Effective, Caring, Responsive and Well-Led. We undertook site visits on 11 and 12 March 2025.
Accidents and incidents were recorded and analysed and a lessons learnt process was in place. Staff were recruited safely and had access to a varied number of training courses to enhance their skills and knowledge. Staff supervisions were being carried out and staff felt supported in their role.
Staff had a good understanding of how to protect people from the risk of abuse and we observed staff to be kind and considerate towards people. Referrals were being made to relevant healthcare professionals and learning was shared amongst the staff team.
Care plans were person-centred and held a record of people’s preferences. Staff had knowledge of people’s communication needs and staff felt supported by the management team.
Contingency plans were in place for emergencies and people’s reasonable adjustments had been taken into consideration. There was a positive culture at this service and staff felt able to approach the management team should they have any concerns.
A clear management structure was in place and quality checks were being carried out; however, not all audits had identified the concerns found during the assessment process as we found concerns in relation to risk and medicines.
Concerns were found in relation to the environment which was not always safe and medicines were not always being stored and administered safely. Concerns were raised in relation to staffing levels and people’s dignity was not always maintained. There was little oversight of daily records, and we found confidential paperwork was not always kept secure. Risk assessments were not always robust enough and there was limited evidence of people’s oral care provision.
We identified breaches of regulation in relation to safe care and treatment and good governance of the service. We have asked the provider for an action plan in response to the concerns found at this assessment.
People's experience of this service
People and their relatives felt safe using this service and relatives praised the care their loved ones received. One relative said, “It may not be the most modern building, but the care is amazing.” Relatives felt staff were well trained and people praised the food. One person said, “We get plenty of drinks throughout the day, juice, milkshakes etc. For breakfast you can have porridge or a cooked breakfast or just toast and cereal. Anything you like really.”
People felt looked after and able to choose how they spend their time. One person said, “You can please yourself what you do when really.” We observed staff to be kind and considerate towards people and people appeared relaxed around the staff team. We observed a range of activities taking place including group and 1-1 activity as well as activities in bedrooms to prevent social isolation.
People told us they were treated as individuals and praised the staff for being on hand should they need assistance. One person said, “They are like my family (staff). You only have to ask for something and they will get it for you. It’s a good place to be.”
While the people we spoke with expressed they were happy with their care, our assessment found elements of the care did not meet the expected standards. We found concerns in relation to people’s dignity. We witnessed staff on several occasions assisting people with their meals by standing over them rather than sitting at eye level. We also witnessed people’s bedroom doors being left open which meant their dignity was not maintained. People’s oral care provision was not always recorded and daily records were not always person-centred. Concerns raised in relation to staffing levels meant care could potentially be rushed.