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Inwood House Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 13 January 2021

During an inspection looking at part of the service

About the service

Inwood House is a care home providing accommodation and personal care for up to 20 older people. 16 people were living in the home at the time of the inspection. Some people using the service were living with dementia.

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

People received support to take their medicines safely. Improvements had been made to medicines management systems since the last inspection. The provider had ensured medicines were stored safely and staff kept accurate records of the support they provided to people. There was clear information for staff about the support people needed to take their medicines.

The home was clean, and the provider had taken additional infection prevention and control measures as a result of the COVID-19 pandemic. Staff had completed additional training to ensure they understood how to implement these measures.

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 requires improvement (published 15 November 2019).

Why we inspected

We undertook this targeted inspection to check infection prevention and control due to a number of COVID-19 cases in the home. An overall rating for the service has not been given following this targeted inspection.

CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found the provider had taken action to manage the risk of harm to people. Please see the safe section of this full 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 carried out on 4 October 2019

During an inspection looking at part of the service

About the service

Inwood House is a care home providing personal care to 18 people aged 65 and over at the time of the inspection. The service can support up to 20 people in one adapted building.

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

Systems to manage medicines were not safe. People did not always receive support to take the medicines they were prescribed and medicines were not stored or recorded correctly.

The registered manager had not always notified us of important incidents in the home, as they are required to.

The systems for checking how the service was operating did not always identify shortfalls. Checks had been completed but did not identify medicines issues or that notifications had not been submitted.

Risks to people’s well-being and safety were assessed and recorded. Staff were aware of these risks and the support people needed.

The registered manager provided good support for staff.

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 May 2019)

Why we inspected

The inspection was prompted in part by notification of a specific incident, following which a person using the service sustained an injury as a result of a fall. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. We found that risks relating to falls had been well managed.

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.

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

We have identified breaches of the regulations in relation to safe care and treatment and good governance at this inspection

You can see what action we have asked the provider to take at the end of this full report.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.

Inspection carried out on 26 March 2019

During a routine inspection

About the service: Inwood house is a residential care home that was providing care to 19 people aged 65 and over at the time of this inspection.

People’s experience of using this service:

• We made recommendations about the management of some medicines.

• People told us they liked living at Inwood house and relatives told us that they knew their relatives were receiving good quality care.

• People told us they felt safe at Inwood House.

• Staff were safely recruited, they knew how to keep people safe from avoidable harm and there were enough staff available to meet people’s needs.

• Accidents and incidents were analysed to prevent re-occurrence.

• The premises was clean and followed infection control guidelines.

• 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.

• People were very positive about staff and management and felt confident that concerns would be listened to.

• People were supported to pursue their hobbies and interests.

• People were supported to maintain relationships with those important to them, and develop new friendships with other people.

• People told us that staff were caring and always willing to support people.

• Rating at last inspection: This service was rated Good at the last inspection (published 22 December 2016).

Why we inspected: This inspection was scheduled based on the rating at the last inspection.

Follow up: We will continue to monitor this service to ensure people using this service receive high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 8 November 2016

During a routine inspection

Inwood House provides accommodation and personal care for up to 20 older people. At the time of our inspection 19 people were living at Inwood House. The home was last inspected in August 2014 and was found to be meeting all of the standards assessed.

This inspection took place on 8 November 2016 and was unannounced.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

People who use the service were positive about the care they received and praised the quality of the staff and management. Comments from people included, “Staff are very kind, they do things in the right way”, “I feel safe here and that is very important for me” and “The girls are lovely, there’s always someone available when you need them”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Staff understood the needs of the people they were providing care for. People told us staff provided care with kindness and compassion.

Staff were appropriately trained and skilled. They received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training relevant to their role and people’s feedback demonstrated staff put this training into practice.

The service was responsive to people’s needs and wishes. People had regular group and individual meetings to provide feedback about their care and there was an effective complaints procedure. One person told us, “I would speak to (the registered manager) if I had a problem, they would sort it out”.

The provider regularly assessed and monitored the quality of care provided at Inwood House. Feedback was encouraged and was used to make improvements to the service.

During a check to make sure that the improvements required had been made

We found the provider had made improvements to recording systems and guidelines. This supported staff to care for people in a way which promoted their health safety and well -being.

Inspection carried out on 7 August 2014

During a routine inspection

One inspector visited the home and answered our five questions, is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with eight people using the service and receiving written comments from eight people using the service. We spoke with five staff, the manager and a director of the home. We reviewed six care plans and other relevant records.

Is the service safe?

Care plans instructed staff how to meet people�s needs in a way which did not always clearly describe how to minimise risks for the individual. They were not always detailed enough to ensure staff cared for people in the safest way.

We found that unexplained injuries or bruising were not fully investigated and it was not clear what action if any had been taken to minimise the risk of recurrence.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the home understood when a DoLS referral should be made. The home had not made any DoLS referrals in 2014.

We found that medication was administered and recorded in a way which kept people as safe as possible. Staff were properly trained and their competence to administer medicines was checked.

The environment was suitably designed and well maintained. There were hand rails fitted throughout the building and enough space for people to use wheelchairs and other walking aids. Alarm bells were always available within people�s reach.

The home had enough trained staff to enable them to work safely with the people who lived in the home. People told us: ��bells are always answered quickly�� and ��if anything goes wrong the staff are there to help you.��

Systems were in place to make sure that the manager and staff continually monitored the quality and safety of care offered to people.

Health and safety was taken seriously by the home and most of the appropriate safety checks had been completed. This reduced the risks to the people who lived in the home, staff and visitors.

People told us they felt very safe in the home. One person reflected the comments of everyone spoken with when they said: ��I feel very safe, nobody�s ever nasty or unpleasant to you and I love it here��.

Is the service effective?

People�s health and care needs were assessed with them, and/or their relatives, as appropriate. Care plans were detailed and clearly identified people�s needs and how they should be met. They were reviewed regularly and changes were made to meet people�s changing needs. We saw that staff gave support as described in individuals� care plans.

We observed staff meeting people�s needs. Daily notes were detailed and of good quality, they described how staff met people�s needs effectively.

The home offered people a comfortable environment in which to live.

Is the service caring?

People were supported by kind, caring and patient staff. We saw that care staff were attentive, encouraging and positive. Staff communicated with people and encouraged interactions between people using the service. People described staff as: ��good company��.

People's diversity, values and human rights were respected. Care plans were individualised and person-centred. We saw that people were always treated with respect and dignity by the staff team. We saw that people�s choices and preferences were respected and their independence was supported.

Is the service responsive?

We saw that health care was sought in a timely way and the home co-operated with other health care professionals to make sure their healthcare needs were met. However, records of continued healthcare and appointments were not always properly recorded. It was not always possible to see if on-going healthcare was provided by the home.

The home had made changes and improvements as a result of ideas and discussions with people who lived in the home and their relatives.

We saw that the people were confident to approach any of the staff team or the manager if they had any concerns about their care. One person said: ��I could talk to anyone, I trust them all��.

The home demonstrated that they learnt from accident and falls investigations which they completed.

Is the service well led?

We saw that staff were well trained and meeting the needs of people was a priority of the staff team. We saw that communication amongst the staff team was good. Staff told us they all felt part of a strong staff team, whatever their role. They told us they felt: ��valued�� and felt their views were listened to.

The service had a quality assurance system which was generally effective. We saw records which showed that identified shortfalls and ideas people put forward were addressed. As a result the quality of the service was being maintained or improved.

Inspection carried out on 2 July 2013

During a routine inspection

People told us they were happy with the care they received.

Staff were caring and respectful in their interactions with people.

People looked well cared for and their rights to privacy and dignity were maintained.

People were encouraged to make decisions in their daily lives.

A comprehensive range of social and leisure opportunities were offered to people, both in-house and within the local community.

People felt safe within the home. Staff were aware of their responsibilities to recognise and respond appropriately to any suspicion or allegation of abuse.

Staff were given a range of opportunities to develop their knowledge and skills in a way which met their individual needs.

Staff were fully supported and worked well as a team.

People were encouraged to give their views about the service and its development. A clear auditing system was in place to monitor the on going quality of the service provided.