The Poplars Care Home

The Poplars Care Home is a residential care home providing personal and nursing care to up to 43 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 39 people using the service.

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

Staff had detailed information about risks for people. The daily care given to people, however, was not always recorded. We have made a recommendation that the provider reviews this and ensures records reflect the care given.

People and relatives told us they felt the service was safe. Staff understood their role in safeguarding people. The home was clean and safety checks were carried out. Medicines were managed safely. Recruitment checks were carried out safely. The provider had faced some challenges in terms of recruitment but working to overcome these challenges. We received some mixed feedback about staffing, some people told us they occasionally waited for support. There were enough staff to meet people’s needs when we visited the home and staff told us they usually had enough time to support people according to their wishes. All staff, including agency staff, had an induction in to the home and the staff on duty knew people well. 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.

There were systems to assess the quality of the service, which were monitored by the registered manager, with oversight from the nominated individual. People, relatives, and staff gave us mostly positive feedback and told us they had opportunity to comment on the service. Some people and relatives told us they had not been directly asked for feedback, however there were avenues to do this, such as via a suggestion box in the home and people were directed to an on-line review website. There had also been some meetings and surveys used to gather feedback.

The registered manager responded to audits from external agencies and had development plans for the continuous improvement of the service. They had developed a new process to document their daily checks on the quality of the service, but this was not yet in use. There was an ongoing program of redecoration and repair to the home. Staff worked with professionals to monitor and manage people’s health and care needs. The home worked with other organisations and the wider community around social and wellbeing activities for people in the home.

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 December 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service and, in part, due to concerns received about staffing and record keeping. A decision was made for us to inspect and examine those risks.

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 found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service is good, based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe section of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Poplars Care Home on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about ensuring records accurately reflect the daily care given.

Follow up

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.

Systems were in place to allow safe visiting, including screening visitors to reduce any potential infection risk, before they entered the building.

Social distancing was encouraged, and changes had been made to communal areas to promote this. Wherever possible people were isolating in their room during the outbreak to minimise risk.

Staff wore personal protective equipment (PPE). Training in infection prevention and control measures and the appropriate use of PPE had taken place. The manager completed regular observation of staff practice to ensure good hand hygiene and correct use of PPE.

Systems were in place to admit people safely into the home.

A regular programme of Covid-19 testing was in place for people and the staff team. The provider had sourced rapid test kits and these were to be used immediately someone in the home presented with symptoms or if agency staff were needed in an emergency and their Covid status was not known.

Further information is in the detailed findings below.

People’s experience of using this service: People and relatives were positive about the caring nature of staff. One person told us, "I am settled and really happy here."

There were enough staff employed and on duty at any one time to meet the needs of people. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

Accidents and incidents were recorded and analysed, and risk assessments were in place. The manager and staff understood their responsibilities about safeguarding. Arrangements were in place for the safe administration of medicines.

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. At the time of the inspection work was ongoing to strengthen their documentation relating to mental capacity to ensure that records evidenced how staff were following the principles of the Mental Capacity Act 2005.

People told us their privacy and dignity were respected and their independence encouraged. People were able to participate in a range of activities if they chose to do so.

The provider was open and approachable which enabled people to share their views and raise concerns. People told us if they were worried about anything they would be comfortable to talk with a member of staff or the provider.

The provider monitored quality, acted quickly when change was required, sought people's views and planned ongoing improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good report published September 2016).

Why we inspected: We inspected the service as part of our inspection schedule for ‘Good’ rated services.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The service was last inspected in August 2015. At that inspection we found the service did not carry out effective recruitment checks on new staff, did not safely manage medicines and did not effectively manage staff training. These were breaches of our regulations. We did not take enforcement action but required the service to submit a plan telling us how they would be compliant with the regulations. When we returned for this inspection we found the issues identified had been addressed.

Poplars Care Home is located in Thornaby and provides accommodation for up to 43 people who require nursing and personal care. Accommodation is provided over two floors and includes communal lounge and dining areas. Nursing care is provided on the ground floor and residential care on the first floor. There are garden areas surrounding the building which are secure and accessible to people who use the service. A car park is located at the front of the home. At the time of our inspection 38 people were using the service.

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

People and their relatives said people were safe at the service. Medicines were managed safely. People were supported at their own pace to access their medicines when they wanted them.

Recruitment checks were carried out to minimise the risk of unsuitable staff being employed. Staffing levels were regularly reviewed to ensure enough staff were employed to support people safely. People and their relatives said there were enough staff to support people safely.

Risks to people were assessed and plans put in place to minimise the chances of them occurring. Risks to people arising from the premises and equipment were also assessed and reviewed. Accidents and incidents were investigated and recorded to see if any lessons could be learned to prevent repetition. Plans were in place to support people in emergency situations. There was a business contingency plan in place, to advise staff on how a continuity of care could be provided during events that disrupted the service.

Staff had a good understanding of safeguarding issues and procedures were in place to minimise the risk of abuse occurring.

Staff received mandatory training in a number of areas, including fire safety, food safety, infection control, moving and handling, safeguarding and health and safety. Staff spoke positively about the training they received and felt supported by regular supervisions and appraisals.

The service was working within the principles of the Mental Capacity Act 2005. Staff had a working knowledge of the Mental Capacity Act and could describe how they applied its principles when delivering care.

People were supported to maintain a healthy diet and were given choice over what they wanted to eat and drink. People were supported to access external professionals to maintain and improve their health.

People told us they were treated with dignity and respect and we saw examples of this during the inspection. People spoke positively about the support they received, describing it as kind and caring. Relatives we spoke with said staff were caring and kind. Procedures were in place to arrange advocates and end of life care should they be needed.

Care delivered was based on people’s assessed needs and preferences. Care plans were reviewed every month to ensure they reflected people’s current support needs. People and their relatives told us they were involved in planning their care.

People had access to a range of activities, and we saw these taking place during our inspection. Procedures were in place to investigate and respond to complaints.

Staff spoke positively about the culture and values of the service and said the registered manager was supportive and included them, people and their relatives in the running of the service.

Meetings to discuss the running of the service and obtain feedback were held with staff, people using the service and their relatives on a monthly basis. The registered manager and registered provider carried out a number of quality assurance checks to monitor and improve standards at the service. Remedial action was taken when issues were identified.