We carried out a review of the data available to us about The Swallows 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 The Swallows, you can give feedback on this service.
People were supported to see their visitors in the garden, or when this was not possible people were supported to speak to their families on the phone or via video call. The provider sent pictures and videos of events within the residence to the resident's families.
The provider implemented isolation rooms for people infected with Covid19 or for people admitted to the home from the hospital or the community. There was clear information and increased restrictions on staff movement in this area of the home. This effectively reduced the risks of transmission of Covid19 within the home.
The provider had implemented a bubble system, where groups of four patients were grouped in an allocated space. Pictures of each group member were on the wall. This was not mandatory but helped keep the number of people that gathered together at a minimum.
The provider had ensured staff who were more vulnerable to Covid-19 had a risk assessment in place, and where it was not safe for staff to be at work, they had a furlough scheme in place to protect staff and people.
The Swallows is a residential care home providing personal care to 16 people aged 65 and over at the time of the inspection. The service can support up to 19 people.
People's experience of using this service
People continued to remain safe at the service. Staff identified risks for people and developed management plans to mitigate these. People had activities that took place in the home. However, there was a lack of dementia specialist activities in place for people. We have made a recommendation about the availability of specialist activities for people living with dementia.
Staff understood the provider’s safeguarding process. Staff had the knowledge to identify potential abuse and manage safeguarding allegations to protect people.
People were supported by enough staff during the day and night to meet their individual needs. The registered manager completed robust recruitment checks to ensure experienced staff were employed.
Medicines were managed so people had their medicines as prescribed and in a safe way.
People had their nutritional needs met by the service. People said they enjoyed the meals that were provided to them throughout the day.
Health care support was made available to people when their needs changed. People had plans in place so prompt actions were taken to respond to an emergency.
Each person had an assessment and staff identified their health and support needs. Care plans provided staff with enough detail to manage people’s assessed needs.
People said staff were kind and caring towards them. Care and support was carried out in a dignified way that respected their privacy.
There were systems in place to support people who required end of life care. Staff had an understanding of how to provide care at that time.
People had access to a complaints process if they were unhappy about an aspect of their care.
The registered manager assessed the quality of the care through a robust monitoring system.
Partnership working occurred with staff and health and social care professionals.
We have made a recommendation about dementia friendly activities.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The rating for this service was Good. (The inspection report was published on 8 December 2016).
Why we inspected
This was a planned inspection based on the rating of the service at the last inspection.
Follow up
We will continue to monitor information 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.
The service had a registered manager in place. 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 service was last inspected on the 7 June 2016, where we carried out a focused inspection. We found the service had made improvements and was meeting the regulations we inspected. These related to safe. At this inspection we found the service was meeting the regulations we inspected.
People were protected against the risk of harm and abuse. Staff were aware of the different types of abuse and how to recognise and report their concerns of suspected abuse. Staff received on going safeguarding training. People were protected against identified risks. The service had devised risk assessments that identified the risk to people and how staff would minimise those risks. Risk assessments were reviewed regularly to reflect people’s changing needs. People were supported to live in a safe environment that was regularly assessed. The service carried out regular safety audit checks of the environment. Where risks were identified, action was taken in a timely manner to make the environment safe.
People received their medicines in line with good practice. Identified errors were responded to in line with good practice to ensure the risk of poor management of medicines was minimised. Staff received training in safe management of medicines.
People were not deprived of their liberty unlawfully. Staff were aware of their responsibilities in line with the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. Staff received on going MCA and DoLS training and were aware of the correct procedure if they suspected people’s capacity was fluctuating. At the time of the inspection 12 people were subject to a DoLS authorisation.
People received care and support from sufficient numbers of suitable staff. The service carried out robust recruitment processes to ensure staff were suitable to work at the service. Records showed staff had supplied two references, photo identification and a Disclosure and Barring Service [DBS] certificate prior to being employed. A DBS is a criminal check employers undertake to make safe recruitment decisions. The service employed sufficient numbers of staff to ensure people’s needs were met.
People’s consent to care and treatment was sought and respected. Staff encouraged people to make decisions about the care they received. Where people were unable to make these decisions action was taken in their best interests and in line with good practice. Staff respected and encouraged people’s privacy and dignity.
People received care and support from staff that reflected on their working practices. Staff received on-going supervisions and appraisals whereby staff looked at what they did well and areas they required additional support and guidance.
People were supported to access sufficient amounts of food and drink that met their preferences and nutritional needs. People’s dietary requirements were adhered to in response to guidance from health care professionals. People had their health and wellbeing monitored and were supported to have access to health care services when required.
People received personalised care that was tailored to their individual needs and preferences. The service had devised care plans that documented people’s likes, dislikes, life history and medical and health needs. People and their relatives were encouraged to develop their care plans where possible. Care plans gave staff clear guidance on how best to support people in their care.
People were encouraged to raise their concerns and complaints with the service. The service had a robust procedure for receiving and acting on complaints in line with good practice. The service had posters in the communal areas of the home that gave people, their relatives and staff guidance on how to make a complaint. Records confirmed the service acted on complaints in a timely manner seeking a positive outcome.
The service carried out regular audits of the quality of care provided. Audits looked at medicine management, health and safety of the environment and care plans and risk assessments. Records showed audits identified areas of risk which were addressed in a timely manner.
The registered manager actively encouraged partnership working with other health care professionals to improve the care and support people received.
The service questioned the service delivery to drive improvements through quality assurance monitoring. The service reviewed feedback received and devised an action plan to address any issues that had been identified.
The Swallows is a residential care home for older people, which provides accommodation and support for up to 19 people, some of whom have dementia. At the time of the inspection there were 19 people living at The Swallows.
The service was last inspected on 23 and 25 February 2016 and was given an overall rating of Inadequate. At the last comprehensive inspection, the provider was placed into special measures by CQC. We undertook a focused inspection at 4am to look at the areas of significant concern identified at the last inspection. This report covers our findings at the inspection on 7 June 2016. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Swallows on our website at www.cqc.org.uk
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.
We found there were insufficient numbers of staff on duty at night to safely evacuate the building in the event of a fire.
Staff did not always have access to an up-to-date fire risk assessment and fire policy. Not all staff we spoke with were aware of where the current risk assessment and fire policy were located. The service had a file in the staff office area, which contained out of date paperwork relating to the fire safety.
The service carried out fire safety checks, fire alarm drills, emergency lighting checks and other checks relating to the fire safety. However checks were not always undertaken when senior staff were absent. We found three weeks checks were missing, which correlated to times when senior staff were on leave.
The service had carried out Personal Emergency Evacuation Plans [PEEPS]. These documents provide guidance to staff and emergency services on how to safely evacuate someone from a building in an emergency.
The service put in place new window restrictors, which ensured all windows were restricted in line with good practice. The service had updated signage relating to fire exits. Designated fire exit doors were in place and free from obstruction. Fire exits doors were linked to the fire alarm and upon the alarm sounding would automatically open.
Staff were aware of the correct procedure to follow in the event of an emergency and had received fire safety training.
The Swallows is a residential care home for older people which provides accommodation and support for up to 19 people, some of whom have dementia. At the time of the inspection there were 19 people living at The Swallows. 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.
People were placed at significant risk of harm as the provider did not take reasonable steps in relation to fire safety management. The service did not have fire risk assessments, Personal Emergency Evacuation Plans (PEEPs), fire safety audits or functioning fire escapes in place. The service did not have enough staff to meet people’s needs at night. The service did not have sufficient staffing at night to ensure people could be evacuated from the building safely in the event of an emergency. People were at risk of harm as the provider did not have adequate audit systems in place to monitor the safety of the premises and equipment. Records showed electrical hardwiring checks, portable appliance testing [PAT] and legionella water tests were out of date.
People had their liberty restricted without authorisation. Staff had inadequate knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These aim to make sure that people in care homes, hospitals, and supported living services, are looked after in a way that does not deprive them of their liberty and ensures that people are supported to make decisions relating to the care they receive.
People were not always protected against the risk of harm and abuse. Staff were not always clear on the correct procedure in reporting alleged abuse. Staff were unclear of the provider’s whistleblowing procedure. The service did not have an ‘easy read’ complaints procedure in place to support people who found written documentation difficult to understand. People received their medicines in line with their prescriptions. However, the service demonstrated unsafe medicine management in relation to the storage and disposal of medicines.
People were protected against known risks, such as the risk of falling. The service had in place risk assessments which identified known risks and provided staff with guidance on how to mitigate these risks.
People’s consent to care and treatment was sought before care was delivered. Staff were aware of the importance of ensuring consent was obtained prior to giving care. Staff were respectful when consent was not given. Care plans were person centred and detailed people’s likes, dislikes, preferences, history and health care needs. People had access to health care professionals to maintain their health and wellbeing. Records showed people received support and guidance from staff that followed health care professionals’ advice. People’s privacy and dignity was promoted. Staff were aware of the importance of maintaining people’s privacy and dignity at all times.
People were given sufficient amounts to eat and drink throughout the day. The chef provided people with nutritious food that met their nutritional needs. People were able to request additional food that was not available on the menu.
We identified that the provider was not meeting regulatory requirements and was in breach of a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
People using the service and their relatives we spoke with made positive comments about The Swallows. They told us they had no concerns about the care and support they received. One person told us, "It's nice here. People are kind. I must admit the staff are very, very good. They're excellent." A relative told us, "The move here has been the best thing that's happened to her. They have done a lot of work to encourage her to look after herself." Another relative told us, "All the staff seem to be really good - they're attentive."
Our last inspection of 26 September 2012 found there was a lack of suitable arrangements to ensure the staff team had up to date training and supervision to enable them to deliver care and treatment to service users safely and to an appropriate standard. When we inspected the service on 30 April 2013, we found that staff training was up to date, and staff supervision had improved.
The provider monitored the quality of the service by obtaining feedback through residents' meetings and staff meetings, monitoring incidents relating to people using the service and carrying out audits.
Lunch was well organised during our inspection and people received a prompt service and support with eating their meals. However we noted improvements were needed in the way that support was provided to some people who needed additional support.
The staff were supported through regular staff meetings. However, there was a lack of suitable arrangements to ensure the staff team had up to date training and supervision.