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Cathedral Care Centre Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 4 February 2020

During a routine inspection

About the service

Cathedral Care Centre is a residential care home situated Lincoln, providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 36 people.

The service did not have enough staff to meet people’s needs and did not always use sufficient cover when shortfalls arose. Some potential risks were not always identified. People received their prescribed medicines. Accident and incidents were analysed, and action was taken to reduce reoccurrence. Staff received infection control training and used protective equipment to reduce the spread of infection. Safeguarding concerns had been referred to the relevant authority. We found a breach in regulation.

There was an on-going refurbishment and the environment was being improved. However, concerns had been identified in the kitchen and no action had been taken at the time of inspection. People did not always have a choice at meal times. The service did not always have enough food to meet people’s requests. Staff did not always have oversight of people. Staff received training. People’s needs had been assessed prior to admission to the service. Staff worked with other health care professionals. Peoples capacity had been assessed where required. We made a recommendation around the kitchen environment and meal choices.

People were not always supported to have maximum choice and control of their lives. However, staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff did not receive end of life care and felt they were unable to give quality end of life care. Some information was accessible to people, however, other picture boards in communal areas was not complete. The registered provider had a complaints policy. Staff felt they were able to raise a complaint. People’s cultural beliefs were respected. People received a choice of activities.

Some staff did not support people when they displayed distress. People told us they did have choice with elements of their care. Other staff interacted positively with people. Peoples dignity was considered by staff and they felt were treated well.

There was not a positive culture in the service and values were not embedded in to the staff team. Quality assurance processes did not always effectively address shortfalls in the service, however there were plans to improve this. Areas which required improvement were not prioritised to ensure timely action had been taken. The registered manager understood their responsibilities to be open and honest.

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 6 March 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We identified a breach of regulation in relation to staffing at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Inspection carried out on 9 January 2019

During a routine inspection

What life was like for people using this service:

•A breach of Regulation 11 (1) of the Health and Social Care Act (Regulated Activities) Regulations 2014 was identified. This related to people who were subject to Deprivation of Liberty Safeguards not being appropriately transferred from the previous provider.

People received care from kind and compassionate staff.

• The service was clean, however some areas would benefit from redecoration and refurbishment.

• People were cared for by staff who were aware of the signs of abuse, neglect and discrimination.

• Staff knew people well. People and staff had a good relationship and were comfortable in each other’s company.

• People were enable to maintain their independence and have a say in some aspects of the service.

• Staff supported people to live their lives in the least restrictive way possible. The policies and systems at the service supported this practice.

• People were able to give their feedback on the service at resident meetings and were involved in staff interviews.

• People's care was personalised in response to their individual needs.

• The provider had processes in place to measure, document, assess and evaluate the quality of care. However, these processes did not always identify weaknesses in the assessment process.

• The service met the characteristics for requires improvement overall.

• More information about our inspection findings is in the full report.

Rating at last inspection: This was the first inspection for Cathedral Nursing Home since the current provider registered with CQC in October 2018.

About the service: The service provides accommodation and personal care 38 older adults, people living with dementia and younger adults. There were 29 people living in the service on the day of our inspection.

Why we inspected: Why we inspected: The inspection was prompted by a notification of an incident following which a person using the service was suffering abuse from the registered manager. This incident is subject to a criminal investigation and 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 risk of abuse. This inspection examined those risks.

Follow up: We will continue to monitor the service to ensure that people received safe, high quality care. Further inspections will be planned for future dates.