22 August 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was carried out by 1 inspector.
Service and service type
Portelet Manor Rest Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Portelet Manor Rest Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We sought feedback from the local authority and emergency services. We used this information to plan our inspection.
During the inspection
We spoke with 7 people and wrote to 3 relatives about their experience of the care provided. We received feedback from 11 members of staff including the registered manager.
We received written responses from 5 health and social care professionals. We reviewed a range of records. This included 8 people's care and support records and 4 people's medicine administration records. We looked at 3 staff files in relation to recruitment and training. We also reviewed a variety of records relating to the management of the service, including policies and procedures, staffing rotas, accident and incident records, safeguarding records, and quality assurance reports.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
22 August 2023
About the service
Portelet Manor Rest Home is a 'care home' registered to provide personal care to up to 28 older people. At the time of inspection, the home was supporting 23 people, including people with a learning disability and people with dementia.
People’s experience of using this service and what we found
There were inconsistencies in care plans therefore staff did not always have access to the most current information relating to people's care needs. Not all risks to people had been assessed. Quality assurance processes were not always effective. Whilst medicines were generally managed safely, audit checks of medicine administration records were not always completed in line with the provider's policy or best practice. The provider took action to address these shortfalls during inspection.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
The registered manager demonstrated joint working with people and health and social care professionals, who provided support to meet people's health needs. The service involved people's families and advocates as appropriate.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Rating at last inspection
The last rating for this service was good (published 24 June 2019).
Why we inspected
The inspection was prompted in part by notification of an incident following which a person using the service had sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of fire safety, accidents and incidents. This inspection examined those risks.
You can see what action we have asked the provider to take at the end of this full report.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Portelet Manor Rest Home on our website at www.cqc.org.uk.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement and Recommendations
We have identified breaches in relation to consent, safe care and treatment and good governance at this inspection. We have made a recommendation about medicine management.
Please see the action we have told the provider to take at the end of this report.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.