Background to this inspection
Updated
4 June 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one adult social care inspector, an assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. In this case the experts experience was in the care of older people.
Service and service type:
Shakespeare Court 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 purpose built to accommodate 80 people in one building; internally it is divided into four units. However, following the last inspection the provider closed one of the units and is currently operating the home as a 60-bed service. Willow unit on the first floor is dedicated to the care of people with nursing needs. Rowan and Aspen units are on the ground floor and support people with personal care. Rowan is dedicated to supporting people living with dementia.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced on the first day.
What we did:
Before we visited we reviewed information we held about the service such as when the provider told us about serious injuries or events. We reviewed the information the provider had sent us in their Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information in the providers improvement action plan which they have been sending us every month since the last inspection. We contacted commissioners and the local safeguarding team to seek their feedback.
During the inspection we spoke with four people who used the service, three relatives, ten care workers and the cook. We also spoke with the residential care manager, the clinical lead nurse, the training and compliance lead, the registered manager and the compliance and quality manager. We observed people receiving care and support in the communal areas. We looked at six people’s care records. We looked at other records which included medication records, three staff recruitment files, training records, maintenance records, meeting notes, audits and action plans.
Updated
4 June 2019
About the service: Shakespeare Court is a residential care home that was providing personal and nursing care to 39 people at the time of the inspection. Most of the people supported were over the age of 65.
People’s experience of using this service:
People told us they felt safe. Staff knew how to recognise and report concerns about people’s safety and welfare. Improvements had been made to the way staff were recruited, the required checks were done before new staff started work.
Risks to people’s health and welfare were identified and managed. Staff knew about people’s needs and care was delivered in line with people’s care plans. People’s medicines were managed safely.
There were enough staff to make sure people’s needs were met in a timely way. Staff received training and were supported in their roles. Staff were kind and compassionate and treated people with respect.
People were supported to eat and drink a varied diet which took account of their preferences and cultural and religious 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.
Improvements had been made to the way people were supported to spend their time and take part in social interaction and activity.
The home was clean and checks were done to make sure it was safe. There were plans in place to improve to make further improvements to the environment and to the gardens.
The systems for monitoring the quality and safety of the service had improved since our last inspection. The management team and staff were committed to the continuous improvement of the service. The provider now needs to demonstrate these improvements can be sustained and developed over time.
Rating at last inspection: Requires improvement. (Report published 24 October 2018.) Although the overall rating was ‘requires improvement’ the service was placed in Special Measures in October 2018. We do this when services have been rated as 'inadequate' in any key question over two consecutive comprehensive inspections. The 'inadequate' rating does not need to be in the same question. In the case of Shakespeare Court, it was the well led domain which was rated inadequate in October 2018 and March 2018. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.
Why we inspected: This was a scheduled inspection based on the previous rating.
Follow up: We will continue to monitor the service to ensure that people receive safe and effective care. Future inspections will be planned in line with our inspection programme. If we receive information of concern we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk