Queensway House

Queensway House is a care home which is registered to provide accommodation and nursing care for up to 80 people. At the time of the inspection, there were 37 people living in the home.

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

People and their relative told us they felt safe. Staff understood their responsibilities in safeguarding people and had received training.

Risks to people’s health, safety and wellbeing had been identified. Assessments were completed and included guidance from health professionals, where it had been received. Staff were provided with guidance to reduce the risk of harm to people and equipment to support people’s health and mobility was provided.

Medicines were managed safely and were administered by staff who had been trained and assessed as competent. We were assured by the measures taken to help ensure the prevention and control of infection. The service was facilitating safe visits for family and friends, in accordance with Government guidance.

Staffing levels were reviewed regularly by the manager to ensure there were enough staff to meet people’s needs. Staff were recruited safely to the service with all relevant pre-employment checks completed.

Quality assurance processes had been implemented since our last inspection. The manager was using a wide range of tools, and seeking feedback, to monitor and improve safety at the service and the quality of care provided. The service development plan recorded actions required following audits and checks. Work remained ongoing to achieve the actions detailed and for systems to fully embed in everyday practice. Feedback from professionals working at the service was positive.

Relatives gave mixed feedback on the engagement they had with the service but felt confident they would be listened to if they raised any concerns.

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 10 June 2021).

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

We carried out an unannounced focused inspection of this service on 23 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safety of people living at the service, the induction and support of temporary clinical staff, quality assurance and record keeping.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-Led which contain those requirements.

We also 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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Queensway House on our website at www.cqc.org.uk.

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.

Queensway House is a residential care home which provides nursing and personal care for up to 80 people aged 65 and over. At the time of the inspection, there were 42 people living in the home.

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

Care records were not always accurately updated as people’s needs changed. Management oversight of these risks did not identify themes or trends so that action could be taken if required.

Staff had been recruited with the necessary checks being completed. However, induction of clinical staff required further improvement.

Staff understood safeguarding procedures and how to report concerns. They were able to describe to us what they should be observant for and the types of abuse vulnerable people were prone to. However, incidents that required reporting were not always completed in a timely manner.

Oversight and management of the service had been insufficient, it had not identified the shortfalls we found on inspection. The interim manager and provider had not implemented an existing quality assurance system to ensure good and safe care was provided to people.

Relatives felt that limited information had been shared with them during the pandemic at a time when visiting was difficult.

People were protected against the risks associated with the current COVID - 19 pandemic as infection prevention and control procedures were effectively implemented.

People told us they felt safe and there were sufficient numbers of staff to support them. People received their medicines as prescribed and medicines were safely managed.

During the inspection, the provider started to take positive action to address these concerns.

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 11 January 2019). This service has now been rated requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about safe care and treatment and managerial oversight of the quality of care provided. A decision was made for us to inspect and examine those risks. During this targeted inspection, we identified further concerns relating to personal care, wound management, recruitment and induction and leadership within the home, so we widened the scope of the inspection to a focused inspection of the key questions of safe and well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The overall rating for the service has changed to requires improvement. This is based on the findings at this inspection.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and good governance at this inspection.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

This inspection took place on 19 and 25 October 2018 and was unannounced.

Queensway House provides care and support to up to 80 people some of who live with dementia. At the time of our inspection 56 people were living at the service.

The home had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and staff told us at times there were not sufficient numbers of staff deployed and at times experienced delays when seeking assistance. Our observations on the day however did not support these views as we saw staff were attentive and responsive to people's needs. Care records were not consistently reflective of people’s changing needs, however staff were aware of what support people required.

People felt safe at the service, staff had received relevant training on how to safeguard people and understood their responsibilities to report any concerns. Risks to people’s safety and well-being were identified and managed to keep them safe from harm. Relevant pre-employment checks had been completed for all staff and safe recruitment practices followed. Medicines were stored appropriately, administered to people as the prescriber intended, managed safely and checked regularly. People lived in a clean and hygienic environment and were cared for by staff who followed robust infection control procedures.

People felt staff were well trained. Staff had attended relevant training to understand their role and spoke positively about the training they were provided with. Staff felt supported and had regular supervisions and appraisals. The registered manager was in the process of reviewing how people’s consent to the care they received was captured in their care plans. Staff were aware of how to support those people who may have not been able to provide their verbal consent. People’s nutritional needs were met and responded to when people were at risk of weight loss. The environment was undergoing a planned renovation and decoration.

People told us that staff were friendly and respected their privacy. Staff knew people well and were knowledgeable about people’s individual needs and demonstrated a caring approach. People's privacy and dignity was promoted.

People received care that responded to their individual choices and promoted their independence. People and their relatives were involved in planning how people`s support would be delivered. People were supported to pursue hobbies and interests. People were able to have visitors without restriction and able to see them in privacy. People were encouraged to provide feedback on the service they received and knew how to make a complaint. Their feedback was used to improve the quality of care they received.

People’s care records were not always updated in a timely manner when people’s needs changed. People, relatives and staff were positive about the registered manager and felt they were visible and approachable. Staff were encouraged to attend team meetings which were held regularly.

The provider operated systems that constantly monitored and reviewed the quality of care people received. The areas identified at this inspection as requiring improvement the provider took action to immediately address these. Notifications required to be sent to us were made in a timely manner.