During an assessment under our new approach
Date of assessment: 5 February to 11 February 2025. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises, and the care provided, and both were looked at during this assessment. The service was providing regulated activity to 33 people at the time of the assessment. We did not carry out a formal Short Observational Framework for Inspection (SOFI) as people were using various areas of the large premises but we did spend time observing and talking to people and relatives. The registered manager had left in November 2024 with a Regional Manager covering until December 2024. The service was now being managed by an interim manager supported by a Quality Assurance Manager and a Senior Manager. Prior to the inspection we received concerns from health professionals and relatives about increased safeguarding alerts, staffing, training and responding to peoples’ health and wellbeing needs.
During the inspection we found 3 breaches of regulation in relation to , governance, safe care and treatment and safeguarding. We found gaps in the governance and overview of the service. The interim manager had been appointed to address this and although there were improvements to be made to ensure good oversight and staff training and induction, the management team were aware and working hard to progress an improvement agenda. There was improved support from Head Office with regular meetings. However, oversight and subsequently safe monitoring and support for people with diabetes, dementia and general bowel management did not always ensure people were safe. Staff could access care plans and updated people's care notes on electronic devices. However, care plans were not always detailed about care needs or followed by staff relating to safeguarding, dementia, bowel and diabetic care. Not all staff had the information they needed to meet peoples’ needs. Staff monitored people's outcomes such as falls and knew what to do. People were supported to eat and drink, and all food was prepared on the premises. There had been some confusion about which health partners had responsibility for some health care needs, but this was now being addressed. Staff worked well with other health services such as hospice community nurses to make sure care was delivered effectively and had a better relationship with a new GP surgery. We saw that staff were kind and caring towards people, and we received positive feedback from relatives. Relatives told us there had been a lot of changes in staff and management but felt that in general staff knew people and their needs well. The staffing team was becoming more stable, and relatives noted an improvement. A new activities co-ordinator had been recently appointed after the previous one had left and although their staff induction had not yet happened there was evidence of activities and engagement for people. Relatives and people spoke in a positive way about activities and there were plans to further improve this aspect. The home was kept clean and comfortable apart from issues relating to continence care for one person which was being addressed and was decorated and furnished to a high standard. Staff were starting to seek feedback from people and their relatives to help them make improvements.