We carried out a review of the data available to us about Thames View on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Thames View, you can give feedback on this service.
People’s experience of using this service:
Staff understood their responsibilities in safeguarding people from abuse and knew how to report any concerns they had.
Incidents had been reported to CQC and the local authority where necessary, which ensured that adverse events were investigated and lessons learned.
Assessments had been carried out to identify any potential risks to people and measures put in place to mitigate these.
There were enough staff on each shift to keep people safe and meet their needs. People told us they did not have to wait when they needed support and did not feel rushed when staff provided their care.
Medicines were managed safely. The home was clean and hygienic and staff maintained effective systems of infection prevention and control (IPC).
Staff received an induction when they started work and had access to the training they needed for their roles. Staff were expected to achieve relevant qualifications and met regularly with their managers for supervision and appraisal.
People were supported to maintain good health and to access healthcare services when they needed them.
People enjoyed the food at the home and were encouraged to contribute to the menu. If people had needs around eating and drinking, care plans had been developed to ensure they maintained adequate nutrition and hydration.
People told us the home had a friendly atmosphere and said they got on well with the staff who supported them. Staff engaged positively with the people they supported during our inspection and treated them with kindness and respect.
People had opportunities to take part in a wide range of activities, which were planned to meet their needs and interests.
Communication amongst the staff team was effective, which helped ensure people received safe and effective care. Staff were well-supported by their managers and colleagues and felt valued for the work they did.
There were opportunities for people to give their views about the care they received and their feedback was listened to.
Staff and managers had developed effective working relationships with other professionals involved in people’s care and implemented any professional guidance effectively.
People’s care was designed and planned to meet their individual needs. 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.
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 16 April 2020) and there were multiple breaches of regulation. 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 found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected:
This was a planned inspection based on the previous rating.
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.
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 we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
The provider had supported people to maintain a healthy diet and have access to a variety of food choices. This had assisted people who had been recovering from COVID-19 to steadily improve their weight.
People were supported through the COVID-19 pandemic as appropriate zoning was implemented within the home. This enabled staff to be able to minimise the spread of infection by ensuring areas of the home could be separated to keep people safe.
The home was kept clean and tidy in all areas. The provider had a cleaning rota in place which was checked daily and audited to check for any improvements. The cleaning process included any high touch point areas and the home was sanitised three times a day.
The provider had ensured a high level of personal protective equipment (PPE) stock had been maintained throughout the pandemic. The home was also a PPE hub and able to support other homes in the area should they need additional PPE.
The provider had implemented a robust testing procedure for staff and residents. This ensured good access to testing kits and support to ensure these were completed accurately and in a timely manner.
People and staff had been supported with access to the COVID-19 vaccine. All people that were able to, had received the first dose of the vaccine and the second dose had been booked for people.
The provider was preparing for the visiting process at the home to continue following the recent government announcement and change in guidance. A safe and sterile visiting area had been established previously at the home and this would be used to restart visits. All visitors to the home are required to go through a robust visiting policy which involves temperatures being taken, lateral flow test, health declaration and full PPE is provided.
Home of Compassion is a residential home providing personal and nursing care for up to 78 people in one adapted building. The home supports adults aged 65 and over with a range of physical and mental health needs, including people living with dementia. At the time of our inspection there were 49 people living at Home of compassion.
People’s experience of using this service and what we found
Risks to people’s safety were not always accurately recorded and monitored. Following accidents and incidents, records were not always completed in detail to ensure lessons were learnt and action was taken. This meant investigating concerns and providing safeguarding information was not always consistent, as well as action to mitigate further risk not always being completed in a timely way.
Since the last inspection a new recording system had been implemented to work alongside their data analyst system. There was improvement required to really embed this in to the way of working to ensure good outcomes for all people living in the home. Examples were seen where on occasions this had been followed and people’s care had improved as a result.
Improvements had been made to the overall culture of the service. The registered manager had supported staff throughout the Covid-19 pandemic and staff felt they were able to raise any concerns in regular staff meetings and individual supervision sessions. Staff were aware of their responsibilities in safeguarding people from harm and understood reporting processes and the provider’s policies.
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 16 April 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. This targeted inspection was completed to address specific concerns regarding risks to people’s safety and aspects of the management of the service. A full update on breaches of regulations found during our last inspection will be provided following our next fully comprehensive inspection.
We undertook this targeted inspection to check on a specific concern we had about the way risks to people’s safety were monitored, how safety incidents were recorded and reported and the management systems in place around this. The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.
We have identified areas of improvement in relation to action taken as a result of accidents and incidents at this inspection and have made a recommendation.
Follow up
We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Home of Compassion is a ‘care home’. It delivers care for up to 78 people living in one large building split in to five wings. At the time of our inspection there were 63 people living at the service who had a range of needs including living with dementia and a mental health diagnosis.
People’s experience of using this service
People told us they did not always feel safe or that they mattered. People and their relatives gave us examples of times were staff had not treated them with privacy and respect. We were also told that any issues or complaints raised with the management team were met with defensiveness, which we also experienced during our inspection. There were members of staff that found the management team were not approachable. We received mixed feedback from people and their relatives around being involved in decisions around their day to day care, with some saying staff did not listen to their wishes or choices.
Documentation was not contemporaneous or up to date. Risk were not always appropriately recorded and managed and did not reflect people’s current needs. The registered manager had not informed us and the local authority of all reportable incidents and safeguarding concerns. End of life care was not responsive to people’s needs, and there was limited information on end of life wishes in people’s care plans. People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not always support this practice. Internal audits and quality governance processes did not identify the issues we found during our inspection.
Although the environment was clean and tidy, it was not set up to meet the needs of people with cognitive impairments such as dementia, and there was a lack of meaningful activities. People were not supported to access the healthcare required at times. There were a sufficient number of staff to meet people’s needs. However, some had not received recent appraisal meetings to discuss their performance and development.
People’s needs were assessed before they moved into the service to ensure their needs could be met. We received positive feedback about the food at the service, and the kitchen staff were knowledgeable about people’s dietary needs and preferences. People felt staff knew them well due to a stable workforce with no agency use. There were plans in place to improve care plan records, and the management team ensured they attended local forums and meetings in order to network with other services in the area.
We have made recommendations around risk assessments and mitigation, effective training, the environment, notifying CQC of certain events and the care and dignity provided at 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
The last rating for this service was Good (published 6 April 2017).
Why we inspected
This was a planned fully comprehensive inspection in line with our inspection scheduling based on the service’s registration with CQC.
Enforcement
We have identified breaches in relation to personalised care, need for consent, good governance, dealing with complaints and safeguarding concerns at this inspection. We also identified notifiable incidents that CQC had not been made aware of.
Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Home of Compassion is a care home providing nursing and residential care for up to 78 people, some of whom are living with dementia. At the time of our inspection there were 38 people living at the service.
There was a registered manager in post. 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.
The registered manager had not notified CQC about some significant events. We spoke to the registered manager and the provider’s representative about this, and was assured this would not happen again.
We found a recording issue in relation to someone’s wishes following an accident they had been involved in. The manager accepted this was an issue and planned to contact the provider to have a prompt put on the organisations accident/incident form, so this did not happen again.
People told us that they felt safe and staff had a good understanding of how to keep people safe. Care records contained up to date risk assessments to keep people safe whilst encouraging independence. Accidents and incidents were documented with actions taken to prevent a reoccurrence.
There were sufficient staff to meet people’s needs. Staff were able to spend time with people, and attended quickly whenever anyone requested support. Nurses were available at all times. The service followed safe recruitment practices.
People’s medicines were managed and administered safely.
People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. Staff had received induction training which included completing the Care Certificate and shadowing more experienced staff. Staff had received refresher training to help ensure they remained up to date with best practice and able to meet the expectations and needs of people. All staff received dementia training.
People were supported by staff who had supervisions (one to one meetings) and an annual appraisal with their line manager.
Staff worked in accordance with the Mental Capacity Act 2005 (MCA). People had mental capacity assessments carried out when needed and best interest decisions were recorded. Staff were able to explain what the MCA is and when it applied.
The staff met people's dietary needs and preferences. Staff were able to explain how they would ensure that people had enough to eat and drink; and how they would recognise when someone was not eating or drinking enough. People’s records contained information on what foods they liked, and their dietary requirements.
Staff were caring and treated people with dignity and respect. Staff knew people well. They were knowledgeable about people’s needs and backgrounds. Records contained very detailed life stories that staff had helped people to write.
People were encouraged to be independent and were involved in the running of their home.
Care plans were clear on what people needed support with, were detailed and contained information on people’s lifestyles and preferences. These were reviewed regularly.
People had a range of activities they could be involved in. People were able to choose what activities they took part in and suggest other activities they would like to complete. These took place seven days a week. In addition to group activities people were able to maintain hobbies and interests.
People knew how to complain and if they complained their complaints were addressed.
People thought the home was well managed. Audits were frequent and thorough and had been used to learn and improve.
Staff were involved in the running of the home. Regular meetings took place where staff received important messages and shared good practice. Staff told us they were supported by the registered manager.
The registered manager had built strong links with the local community. Members of the public could join in the home’s activities and also use the facilities of the home which reduced the risk of people becoming socially isolated.