During an assessment under our new approach
Pittsmead Grange Care Home is a care home that can accommodate for up to 50 older people some of whom are living with a dementia. At the time of our assessment there were 44 people living at the service.
This is the first rating of the service since their registration with the CQC. The assessment was prompted in part by concerns raised regarding people’s care and treatment and the management of medicines.
We found the provider was in breach of the legal regulations relating to the proper and safe management of medicines, safe care and treatment, need for consent, person centred care and good governance.
The overall rating of this service is requires improvement.
At the time of our on-site assessment there was a registered manager in post for the service. However, they are now no longer at the service, and an acting general manager is now in post at the service. Throughout our assessment we spoke with the registered manager, regional director and 10 staff including clinical development nurses, care community leads, care staff, chef, maintenance and housekeeping staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Assessments of people’s needs and risks were not always completed or reviewed to ensure they were reflective of people’s needs and wishes. Risks to people were not always assessed, documented and detailed within their plan of care. Staffing levels were observed to be minimal and feedback from people and staff about staffing levels was mixed. Medicines were not always managed and administered safely. Staff did not always work within the principles of the Mental Capacity Act 2005 and the Codes of Practice. People’s care plans were not always person centred, documented or reflective of individual’s preferences, life histories and wishes. Governance and oversight systems were not robust or effective in identifying shortfalls in the service and in driving service improvements. However, the provider started to address some of our concerns during our assessment process.
We have asked the provider for an action plan in response to the concerns found at this assessment.
In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/or appeals have been concluded.