Villarose Rest Home

Villarose Rest Home is a residential care home providing personal care to up 15 people. The service provides support to older people. At the time of our inspection there were 12 people using the service

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

Designated staff kept the building clean and tidy and maintenance checks were in place. Staff were seen to wear appropriate personal protective equipment (PPE) as latest guidance stated. Recruitment procedures were in place and had been improved to be more thorough. One staff member said, “All checks were done before I started.” There were sufficient staff to meet people’s care needs. Safeguarding training was mandatory, staff were aware of the processes to follow to enable people to be safe. Risks were assessed and monitored to ensure individuals safety and promoted their independence within a risk framework. People received their medicines safely.

The manager had a training programme to support staff to improve their skills and knowledge. 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. The manager had systems to reduce the risk of malnutrition and monitor people’s food and drink intake to ensure people received appropriate care.

There were auditing systems to maintain ongoing oversight of the service and make improvements where necessary. Quality assurance systems ensured people were able to give their views of the service.

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 19 January 2023).

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 19 January 2023. 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. Breaches found in safe care and treatment, dignity and respect, need for consent and staffing.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Effective and Well led. which contain those requirements.

The overall rating for the service has changed from requires Improvement to good based on the findings of this inspection.

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.

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

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Villarose Rest Home is a residential care home providing personal care to up 15 people. The service provides support to older people. At the time of our inspection there were 13 people using the service plus one person in hospital.

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

Record keeping related to the administration of some medicines was not consistently completed. Best practice for the administration of medicines was not consistently followed. Some audits were not consistently employed and failed to either identify concerns or drive improvement. Governance systems were not always robust or operated effectively to ensure all regulatory requirements had been fulfilled.

People told us they felt safe, however the provider failed to demonstrate that risks were consistently monitored related to people's health and welfare and in the maintenance of the building. People lived in a home that did not look visibly clean. There were not enough cleaning staff to keep the home clean.

Some care plans did not include all the relevant information on people's behaviours and health conditions. One person’s dignity was not consistently upheld as the provider did not take timely action to protect their privacy. People were not always supported to have maximum choice and control of their lives however staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice but were not evidenced as being followed.

Observations showed people were happy and relaxed in the company of staff. One person said, “They [staff] are so kind and caring.” Feedback on the manager was positive from people. A second person told us, “[Manager], she’s great, we have banter. She gets on well with me and others. I like her.” The manager engaged with people, visitors and staff, through daily interactions and having an open-door policy. People were supported to have access to healthcare professionals and their healthcare needs had been met. People spoke positively about the food and their nutritional needs and preferences were met. One person said, “The food is great, never had something bad. She’s such a good cook, a bit like my mum was.”

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 17 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Following our feedback, the provider and manager have taken positive action to lessen the risk and drive improvement.

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 changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

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 risk management, quality assurance, the management and administration of medicines and creams and staffing levels within the home. We also identified breaches in relation to record keeping around the Mental Capacity Act 2005 and taking timely action to protect someone’s privacy and dignity.

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.

At the last inspection in July 2015 the service was rated Good. At this inspection we found the service remained Good.

This inspection visit took place on 12 September 2017 and was unannounced.

The registered manager had procedures in place to minimise the potential risk of abuse or unsafe care. Staff spoken with were able to identify different types of abuse and had received training in safeguarding adults. One staff member said, “We have training up dated as well so we know the process.”

Medicines were stored in a clean and secure environment. We observed staff followed correct procedures when they administered medication at lunchtime and fully completed associated records. In addition medication audits were now in place regularly to ensure procedures were monitored.

We found staff had been recruited safely, received ongoing training and, were supported by the management team. They had the skills, knowledge and experience required to support people in their care. In addition we found sufficient staff available to meet the needs of people who lived at the home. This was confirmed by all the staff we spoke with.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. In addition we found equipment had been serviced and maintained as required.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had been consulted about their care and had agreed with the support to be provided. We saw people had signed their care plans and consented to their care.

Care records we looked at confirmed people who lived at the home had access to healthcare professionals and their healthcare needs had been met. Staff had responded promptly when people had experienced health problems.

Staff knew people they supported and provided a personalised service in a caring and professional manner. Care plans were organised and had identified care and support required for people who lived at Villarose.

People told us they were happy with the variety and choice of meals available to them. All comments we received were positive about the quality of meals provided and included, “The food is very good here we have a cook who prepares lovely homemade meals.” Also, “The food is always homemade with good choices for us.”

People who lived at the home told us staff were all caring and respectful. Relatives also commented in surveys how caring staff were. We also confirmed this by our observations during the inspection visit.

People who lived at the home were provided with information with regards to support from an external advocate should this be required by them. The service also had information in the reception area of the home in relation to advocacy services in the area.

The management team had a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits and surveys sent to staff, relatives and for people who lived at Villarose. A recent survey from staff, relatives and people who lived at the home returned all positive comments about how the home was run and care provided.

We spoke with people who lived at the home. They told us they could express their views and were involved in making decisions about their care. They told us they felt listened to when discussing their care needs. One resident we spoke with said, 'I didn't think I would settle, however the staff have been wonderful and L' is so kind and caring.'

We spoke with people living at Villarose about their diet and how their nutritional needs were being met. Comments were all positive and included, 'I can have anything I want at breakfast the cook is so obliging.' Also, Always a choice, it doesn't worry me if I don't like something because the cook will always provide an alternative.'

Staff we spoke with told us they felt supported by the manager and told us the recruitment system made sure all the necessary checks had taken place before they began working in the home.

There were a range of audits and systems in place to monitor the quality of the service being provided.

Prior to our visit we contacted Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We were able to speak with residents during the day of the inspection about their care and support. People we spoke with told us they could express their views and were involved in discussions about their care. They told us they felt listened to when discussing their care needs. One resident told us, 'The place is tops.' A relative we spoke with said, 'We came to visit and we were impressed with the warmth of the staff and the homely atmosphere.'

Comments from other residents were all positive and included,

'Lovely staff, good food and the staff try and keep us entertained.'

'Very clean home the staff do a wonderful job.'

'Always enough staff and management around if you need help.'

We contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.