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Regency Hall Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 March 2020

About the service

Regency Hall is a residential care home for up to 68 older people. At the time of inspection they were supporting 50 people across three floors. There was a fully equipped fourth floor, the provider was planning to open this floor in the future. There was also a separate activities area at the top of the home which included a hairdressing salon. People had access to communal areas on each floor and there was an accessible garden.

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

Medicines were not always managed to reduce the risks associated with them to ensure people received them as prescribed. There were mostly enough staff deployed to meet people’s needs but at some points of the day this was not the case. This meant risks to people’s safety were not always managed and people were not always meaningfully engaged. The provider’s quality assurance systems did not always highlight the areas for improvement. We made a recommendation to the provider to consider how people's preferences for activities and interests could be met.

People had care plans which were detailed, personalised and included how risk should be managed. They were regularly reviewed and staff were aware of people’s changing needs. The systems in place to monitor people’s health and wellbeing were effective and led to good outcomes for people. People were supported to maintain good health and nutrition; including partnerships with other organisations when needed. Lessons were learnt from when mistakes happened.

People received caring and kind support from staff who respected their dignity and privacy. They were encouraged to be independent and staff understood their needs well. 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.

There was good communication with staff and people who lived at the home to ensure their feedback was followed up. Communication was adapted to be accessible for people when there was an assessed need. The registered manager and the nominated individual were approachable and there were meetings in place which encouraged people and staff to give their feedback. People and relatives knew how to raise a concern or make a complaint. The environment was adapted to meet people’s needs.

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 1 November 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and quality of care. A decision was made to bring our inspection forward and examine those risks.

We found no significant evidence during this inspection that people were at risk of harm from this concern. However, we did find found evidence that the provider needs to make improvement in medicines management and governance. Please see the safe and well led sections of this full report.

Enforcement

We have identified one breach in relation to medicines management at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Inspection areas

Safe

Requires improvement

Updated 13 March 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 13 March 2020

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 13 March 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 13 March 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 13 March 2020

The service was not always well-led.

Details are in our well-Led findings below.