Saltshouse Haven Care Home

Saltshouse Haven Care Home is a residential care home providing personal care to a maximum of 150 people aged 65 and over. At the time of the inspection 133 people were using the service. The service is separated into five 'lodges' called Bilton, Meaux, Preston, Coniston and Seaton. Each lodge can accommodate 30 people and has its own lounge, dining area, bathrooms and bedrooms. Bilton and Seaton lodge support people living with dementia.

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

There were inconsistencies in the quality of care being provided across the lodges. This was due to a lack of oversight and effective monitoring systems in place. Whilst some people received a good standard of care in their lodge, others didn’t.

The provider lacked the appropriate systems and processes to drive forward improvements in a timely manner. The provider's own systems of oversight had not identified the concerns we found during the inspection.

Systems in place to safeguard people from abuse were not always followed. The registered manager did not always responded to concerns in a timely manner and was not aware of how some people were spoken to by some staff.

There was insufficient staff to meet people’s needs. People and staff, from a number of lodges, reported delays in providing care due to staff shortages. The tool the provider used to calculate staffing levels demonstrated that staffing levels were too low. Staff did not always benefit from training and constructive supervision to support them in their role.

We identified a number of Infection Prevention Control (IPC) concerns. Whilst most of these concerns were identified on one unit, there were minor concerns on other units also. The majority of the concerns we identified had been raised with the registered manager at the last two inspections. Not enough action had been taken to reduce this risk.

The mealtime experience for people was poor and did not always follow best practice. People gave mixed feedback about the meals provided. We made a recommendation about this.

Staff did not have much contact with the registered manager. Whilst most staff felt supported by their lodge manager, we received mixed feedback about the approachability of the management team and if they would act on concerns raised.

People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Recruitment and selection processes were followed to ensure staff employed were safe to work with people.

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

Rating at last inspection

The last rating for this service was good (Last report published 7 January 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safety, staffing, safeguarding and provider oversight at this inspection.

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

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Visits were arranged in line with government guidance.

Staff were wearing personal protective equipment (PPE) in line with government guidance.

People were part of a regular testing programme.

Staff had received training in infection prevention and control (IPC) and IPC champions were in place.

Staff had received the COVID-19 vaccination as a condition of their deployment.

Saltshouse Haven Care Home is a residential care home providing personal care to a maximum of 150 people aged 65 and over. The service has five separate lodges Bilton, Meaux, Preston, Coniston and Seaton; each can accommodate 30 people and has its own lounge, dining area, bathrooms and bedrooms. Bilton and Seaton lodge supports people living with dementia.

We found the following examples of good practice.

• The service communicated with relatives to promote people's wellbeing. People were supported to take regular exercise and join in activities to maintain their wellbeing.

• Visits were arranged in line with government guidance.

• Staff were wearing personal protective equipment (PPE) in line with government guidance.

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

Why we inspected

The inspection was prompted in part due to concerns received about infection control. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this report.

Saltshouse Haven Care Home is a residential care home providing personal care to a maximum of 150 people aged 65 and over. The service has five separate lodges Bilton, Meaux, Preston, Coniston and Seaton; each can accommodate 30 people and has its own lounge, dining area, bathrooms and bedrooms. Bilton lodge supports people living with dementia.

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

Staff knew how to safeguard people from abuse and how to minimise the risk of harm. Staff were recruited safely and there were enough members of staff on each of the lodges. However, Bilton lodge needed monitoring when staff escorted people at short notice to hospital for appointments as this had the potential to leave the busy lodge short-staffed. This was discussed with the registered manager and provider during feedback and they assured us it would be addressed.

People received their medicines as prescribed and their health and nutritional needs were met. People had access to a range of healthcare professionals when required. An incident when a person did not receive timely professional input is currently being investigated so that any lessons can be learned to improve practice.

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 had their needs assessed and care plans contained information to guide staff in how to support people in line with their preferences and wishes.

Staff were described as kind, friendly and caring. They respected people’s privacy and dignity. Relatives could visit the service at any time and were kept informed of important issues.

Staff received induction, training and supervision to ensure they felt confident when delivering care to people.

There were systems in place to monitor the quality of the service and to respond to concerns and complaints. People felt able to raise 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 requires improvement (published 1 August 2017). There were concerns with how the service was governed and how staff respected people and promoted their dignity.

Since this rating was awarded the registered provider has changed; the service was registered with us on 3 December 2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the provider registered with CQC.

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.