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Inspection Summary


Overall summary & rating

Good

Updated 15 September 2018

This inspection took place on 14 and 15 August 2018 and was unannounced.

County Homes is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is registered to provide personal care and nursing care for up to 90 people, however the manager told us that the maximum number of people accommodated is now 82 because a number of rooms were registered for double occupancy but are no longer shared.

The home is required to have a registered manager. 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 home had a registered manager who had been in post for several years.

The manager told us that all of the people accommodated were living with dementia and required nursing care. The home was divided three units known as Chester, Lancaster and York. Each of these had a unit manager. Each unit was further divided between ground and first floors, which meant that the maximum number of people living in each area was 14. Each area had its own lounge and dining room. Three areas accommodated men only and two accommodated women only.

At our last inspection of County Homes in July 2017, we found a breach of Regulation 9 of the Health and Social Care Act: Person-centred care, because care plans did not always provide sufficient details to enable staff to meet people's needs safely, and planned care was not always evidenced as provided. During this inspection we found that improvements had been made to the care plans and there was no longer a breach of regulations.

Relatives we spoke with told us that they felt their family members were safe in the home and that they had no concerns regarding their care. They told us the staff were kind and caring and protected the dignity and privacy of people living in the home. Visiting relatives were made welcome and were encouraged to be involved in the care and support of their loved one.

Staff were recruited safely. Staff were supported in their role through an induction, supervisions and an annual appraisal. Training was provided to ensure staff had the knowledge and skills to meet people’s needs.

People’s medicines were managed safely.

Applications to deprive people of their liberty had been made appropriately. Records showed that consent was sought in line with the principles of the Mental Capacity Act 2005.

Feedback regarding meals was mainly positive, however there were some room for improvement. Staff were knowledgeable about people’s individual nutritional needs and preferences.

A range of social activities was provided to keep people stimulated and occupied.

The manager and the area director completed regular quality monitoring audits which identified any areas needing improvement. Action plans were agreed and implemented by the manager and the staff team.

Inspection areas

Safe

Good

Updated 15 September 2018

The service was safe.

People’s medicines were stored and handled safely.

There were enough staff to meet people’s support needs and robust recruitment procedures had been followed to ensure that new staff were of good character.

Maintenance records showed that regular checks of services and equipment were carried out by the home’s maintenance team, and testing, servicing and maintenance of utilities and equipment was carried out as required by external contractors.

Effective

Good

Updated 15 September 2018

The service was effective.

People’s individual dietary needs and choices were catered for and their nutritional status was monitored.

The home complied with the requirements of the Mental Capacity Act.

Staff received regular training and supervision to ensure they knew how to work safely and effectively.

Caring

Good

Updated 15 September 2018

The service was caring.

We observed that staff protected people’s dignity and individuality by respecting their choices and preferences. Staff treated people with kindness and respect.

People’s relatives were made welcome when they visited and were involved in their care.

People’s personal information was kept securely to protect their confidentiality.

Responsive

Good

Updated 15 September 2018

The service was responsive.

The care files contained comprehensive assessments and plans that were updated monthly.

A range of social activities was provided to keep people stimulated and occupied.

The home’s complaints procedure was displayed and complaints had been addressed appropriately.

Well-led

Good

Updated 15 September 2018

The service was well led.

The home had a manager who was registered with CQC.

Regular meetings were held for staff and for the families of people living at the home.

The manager completed a series of quality audits which were accompanied by action plans for improvement as needed.