Pranam Care Centre

Updated 5 January 2023

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

The inspection was conducted by 3 inspectors and an Expert by Experience on the first day of the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. A member of the CQC medicines team visited on a second day to inspect how medicines were being managed.

Service and service type

Pranam Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Pranam Care Centre 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at all the information we held about the provider including feedback from the local authority. 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.

During the inspection

We spoke with 10 people who used the service, 1 visiting relative and a visiting healthcare professional. We also observed how people were being cared for and supported. Our observations included 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.

We spoke with staff on duty who included the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at a range of records used by the provider for managing the service. These included the care records for 4 people, staff recruitment, training and support files, records of accidents, incidents, complaints and meeting minutes.

We looked at how medicines were being managed. We also conducted a partial tour of the environment.

Updated 5 January 2023

About the service

Pranam Care Centre is a residential care home for older people and younger adults with mental health support needs. The care home accommodates up to 50 people in two joined buildings over two floors. It is owned by the provider Woodhouse Care Homes Limited. At the time of our inspection 44 people were living at the service.

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

Sometimes staff supported people in an unsafe way when they were walking and this placed them at risk.

Staff were not always respectful towards people.

The provider's systems and processes for monitoring risk and quality had not always identified where improvements were needed.

People using the service were happy with their care and support. They told us their needs were met and they were able to make choices about their care. People felt they were well treated by staff and had good relationships with them.

Care was appropriately planned, and staff followed care plans, working with other professionals to review and monitor people's health and wellbeing. The staff also assessed risks to people's safety and wellbeing and planned care in the least restrictive way.

People received their medicines safety and as prescribed.

People had opportunities to take part in a range of different social and leisure activities.

The provider investigated and responded to adverse events, such as accidents, incidents and complaints. The provider undertook a range of audits and checks. They planned ways to improve the service.

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.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 18 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we some found improvements had been made but the provider remained in breach of regulations.

This service has been rated requires improvement or inadequate at all inspections since registration in June 2015. In 2020, we imposed additional conditions on the service requiring the provider to send us information each month. These conditions remain in force and we will use this information to help monitor the service and to check they are making the required improvements. We will also ask them for an additional action plan relating to the new concerns we have identified.

Why we inspected

We carried out an unannounced inspection of this service on 15 July 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. We found improvements had been made to areas where there were previous concerns. However, we found there was a concern with some of the interactions between staff and the people being cared for, so we widened the scope of the inspection to include the key question of caring.

This report only covers our findings in relation to the Key Questions Safe, Caring, Responsive and Well-led.

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 has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pranam Care Centre 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 breaches in relation to safe care and treatment, dignity and respect and 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.