Shannon Court Care Centre Also known as Shannon Court Care Centre

Shannon Court Care Centre is a residential care home which provides long and short-term care for up to 78 people in single rooms. The Home has 3 separate designated areas in which the 3 different types of care are provided. Darcy Lounge supports people with general nursing needs; Oaken lounge supports people living with dementia who also need a nurse; Lantern Lounge supports people living with dementia. On the day of the inspection there were 78 people using the service.

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

Systems in place helped safeguard people from the risk of abuse. Assessments of risk and safety and supporting measures in place minimised risks. Staff managed people's medicines safely. We saw staff followed infection prevention and control guidance to minimise risks related to the spread of infection. Staffing levels were sufficient to meet people's needs and managers recruited staff safely. Staff followed an induction programme, and training was on-going throughout employment.

Staff thoroughly assessed people's needs prior to a service starting. Care plans included information about support required in areas such as nutrition, mobility and personal care to help inform care provision. Staff made appropriate referrals to other agencies and professionals when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they were well treated, and their equality and diversity were respected. People felt staff respected their privacy and dignity and took into account their views when agreeing on the support required. Staff identified people's communication needs and addressed these with appropriate actions.

Managers responded to complaints appropriately and used these to inform improvement to care provision. The provider was open and honest, in dealing with concerns raised. The management team were available for people to contact and undertook regular quality checks, to help ensure continued good standards of care.

The provider and registered manager followed governance systems which provided effective oversight and monitoring of the service. These governance systems and processes ensured the service provided to people was safe.

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 5 October 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 comprehensive inspection of this service on 5 August 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance of the service.

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. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

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 Shannon Court Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Shannon Court Care Centre is a care home which provides long and short-term care for up to 78 people in single rooms, most of which are en-suite. The care is provided over three floors. Shannon Court specialises in dementia care. On the day of the inspection there were 68 people using the service.

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

A new electronic recording system for medicines had been implemented at the service. We found that governance arrangements did not provide assurance around the safe handling of medicines. In particular, changes to people’s medicines were not well managed, which had placed some people at risk of harm. Medicines handling had not been audited and staff competency had not been assessed. Reports were not completed to support learning from incidents.

There were appropriate systems to help safeguard people from the risk of abuse. Staff had completed training and understood the issues relating to safeguarding. Staffing levels were appropriate to meet people’s needs and staff were recruited safely.

Individual risks were assessed and monitored. Health and safety measures were in place and we were assured appropriate and effective infection control and prevention measures were in place. Care plans included appropriate health and personal information and were person-centred.

Complaints were responded to in a timely and appropriate way. Quality monitoring was regularly undertaken to help ensure standards were maintained. The service engaged well with people who used the service, relatives and staff. Relatives were communicated with regularly to inform them of any incidents or changes to current guidance.

The provider took learning from the results of audits to help inform continual improvement to service provision. The home worked well with partner agencies and other professionals.

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 9 March 2021) and there were two breaches of regulation. At this inspection the service remains rated as requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

We carried out an unannounced focused inspection of this service on 26 January 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 safe care and treatment and good governance.

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 of safe and well-led which contain those requirements.

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 remained requires improvement. 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 Shannon Court Care Centre on our website at www.cqc.org.uk.

Enforcement

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 a repeat breach in relation to good governance at this inspection. 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 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.

Shannon Court Care Centre is a care home which provides long and short-term care for up to 78 people in single rooms, most of which are en-suite. The care is provided over three floors. Shannon Court specialises in dementia care. On the day of the inspection there were 69 people using the service.

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

There were some issues with medicines management and recording of medicines which meant we were not assured that people were given their medicines safely. Audits had picked up some issues, but these had not been addressed appropriately. The most significant issues were dealt with immediately following the inspection.

Some staff were not wearing their face mask appropriately, i.e. over both their mouth and nose. This was dealt with immediately by the registered manager.

There were robust systems in place to record and follow up safeguarding concerns. Risk assessments were in place and up to date. The service had the appropriate health and safety certificates in place.

Staff were recruited safely and there were enough staff on duty to meet the needs of the people using the service. Staff felt staffing levels were generally good.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Audits relating to areas such as health and safety, falls, catering and weight management had identified issues, learning had been taken and these had been addressed.

The service was inclusive, and people’s diversity was respected. People we spoke with felt well cared for and told us staff treated them well.

Staff felt well supported by the management team and communication was good with people who used the service and their relatives. The service worked well with partner agencies.

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 2 April 2020) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had not been sustained and the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We received concerns in relation to the governance of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 remained requires improvement. This is based on the findings at this inspection.

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

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 Shannon Court Care Centre on our website at www.cqc.org.uk.

Shannon Court Care Centre is a care home which provides long and short-term care for up to 78 people in single rooms, most of which are en-suite. The care is provided over three floors. Shannon Court specialises in dementia care. On the day of the inspection there were 64 people using the service.

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

There had previously been issues with medicines management and governance systems not picking up issues around records. At this inspection there had been improvements in the management of medicines, but there were still some issues with record keeping.

The service had systems in place to ensure people were kept safe. The service assessed and managed risks competently. Staff were recruited safely, and documentation and observations evidenced sufficient staffing levels to meet people’s needs. Appropriate measures were in place to ensure the effective prevention and control of infection.

People’s needs were fully assessed prior to being admitted to the home. There was information within the care files, about people’s health and support needs. However, some care plan information was not complete and up to date. The service worked well with other agencies and professionals. People were supported with all their nutritional and hydration needs. Staff training was thorough and on-going.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were well looked after and treated without discrimination. People and their relatives were encouraged to be involved with their care and support. People’s dignity and privacy was respected, and independence promoted.

Care was planned in a person-centred way and people’s choices and preferences adhered to. People’s communication needs were met appropriately. People were supported to maintain relationships and to follow their interests. There was a programme of activities, outings and entertainment. Complaints were dealt with appropriately.

The registered manager had a clear improvement plan for the home and was working through this to achieve better standards of care. We observed staff working together as a team. Learning and improvement was taken from a number of audits relating to all aspects of the running of the home. Issues identified had been addressed with actions.

We identified a breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to good governance.

We also made a recommendation about to medicines management. Details of action we have asked the provider to take can be found at the end of this report.

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 28 November 2018)]. There was also an inspection on 28 May 2019 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

There had previously been multiple breaches of regulation. 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 now only had a breach of one regulation relating to governance.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

The last inspection was undertaken under the previous provider registration on 6 December 2016 when the service was rated good in all domains and overall. At this inspection we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to safe care and treatment, nutrition, dignity, person-centred care and good governance. We also made recommendations with relation to implementing overviews of safeguarding concerns and falls and ensuring activities were person-centred.

Shannon Court Care Centre 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.

Shannon Court Care Centre accommodates up to 78 people in one adapted building. The service provides nursing and personal care in three separate units over three floors. One of the units specialises in providing care to people living with dementia. At the time of the inspection there were three vacancies and two people were in hospital.

There was an acting manager in place at the home who was in the process of registering with the Care Quality Commission. 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.

Leadership at the service had been inconsistent for a period of time. Documentation was poor and there was a culture of ineffective responses to people’s basic needs and dignity. There was a lack of guidance for the staff around the importance of providing person-centred, respectful care for all the people who used the service.

Systems were not always effective in ensuring medicines were administered, recorded and stored safely. There were appropriate safeguarding and whistle blowing policies in place and staff had a good awareness and understanding of them. There were enough staff on duty and recruitment systems were satisfactory.

Risk assessments were completed but individual risk assessments were not always effective. Health and safety measures were in place and accidents and incidents were recorded.

Staff completed an induction on commencing work at the service. However, we noted that some sections of the induction booklet were incomplete. Staff had completed essential training and refresher training was ongoing. Staff would benefit from more in-depth dementia training. The premises were not as dementia friendly as they could be.

The food choices were limited and there was a lack of fruit and vegetables on the menu. Pureed food was unappetising, and the lunchtime experienced could have been improved with more attention to detail.

The home was working within the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

Staff were hard working, cheerful and caring. They worked as a team and were friendly and respectful. Communication between relatives and the home was good. Independence was encouraged and there was evidence within care plans of the involvement of the person and their relatives with care planning and reviews of care.

We saw an instance where a person’s dignity was compromised which was unacceptable. Although oral hygiene care plans were in place, there was a lack of oral hygiene in practice for a significant number of people.

There was a service user guide with information for people who sued the service and their relatives.

Some care files were disorganized, and things were out of place. Documentation within care plans was person-centred but this did not always translate into actions. There were some activities within the home but there was a lack of one to one or small group activities. Some staff had undertaken training in end of life care and some care files had people’s wishes documented. However, others did not, nor were any reasons for this recorded.

An appropriate complaints policy was in place and people were aware of how to raise a concern. We saw a number of compliments received by the service.

People described the manager as approachable. There were regular supervisions, appraisals and staff meetings in place.

Handover documentation between staff shifts was poor. None of the sheets had been checked or signed by the manager as was the procedure. There were a number of audits in place, but not all of these were completed appropriately. Audits had not been checked by the manager or provider as required.