Corbett House Nursing Home

Corbett House Nursing Home is a residential care home providing personal and nursing care to up to 35 people. The service provides support to younger adults and older people, including people living with dementia. At the time of our inspection there were 22 people using the service.

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

Improvements had been made to the provider’s quality assurance systems and processes. People's medicines were now stored, administered, and managed safely. Action had been taken to ensure the safety of the premises mitigated risks to people and staff. The provider had effective procedures in place to maintain the hygiene and cleanliness of the home.

Since our last inspection there had been changes in management. A new home manager was in post.

The provider had safeguarding systems and processes in place to help keep people safe. Staff knew people well and understood their individual risks and knew how to protect them from avoidable harm. Staff were recruited safely and had received relevant training to enable them to carry out their roles effectively. Staffing arrangements met people’s needs. The provider had procedures in place enabling staff to record and report any accidents or incidents. The manager analysed these to help them identify any patterns or trends to prevent similar incidents or themes from reoccurring.

Staff supported people 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.

Staff knew people well and were knowledgeable about their health conditions and needs. People were referred to healthcare professionals as required. People were supported to maintain a healthy and nutritious diet and were offered choices. People had their needs assessed.

The manager completed a variety of audits and checks and was developing these further to ensure systems were robust and effective.

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 21 June 2023) and there were breaches of regulation 12 and regulation 17. We served a Warning Notice in relation to good governance. 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 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, Effective and Well-led which contain those requirements.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Corbett House Nursing Home 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.

Corbett House Nursing Home is a residential care home providing personal and nursing care to up to 35 people. The service provides support to younger adults and older people, including people living with dementia. At the time of our inspection there were 20 people using the service.

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

The provider’s quality assurance systems and processes were still not as effective as they needed to be. We found improvements needed to be made to people’s medicines in one part of the home as these were not consistently stored, administered, and managed safely.

The provider's checks to ensure the safety of the premises did not consistently mitigate risks to people and staff as timely improvement action had not always been taken. The provider had procedures in place to maintain the hygiene and cleanliness of the home however, these were not always effective.

There had been changes to the staff running the home with a new manager and deputy manager only being in post for a few days when we undertook our inspection.

People and relatives shared positive feedback about how staff supported their care needs and people felt safe.

Staff understood how to recognise and report potential abuse. The risks associated with people’s individual care needs were assessed and plans were in place to manage these.

Staff were recruited safely. There were enough staff to care for people, and people did not have to wait long if they wanted assistance.

The provider had procedures in place enabling staff to record and report any accidents or incidents. However, actions identified were not consistently addressed, therefore there was a lack of continuous learning and improving people’s safety and outcomes.

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 supported to access the health care they needed. People had a nutritious diet, and they enjoyed the food offered. People had their needs assessed and the provider had plans to continue with improvements to the home environment to ensure this was adapted to meet people’s needs.

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 25 February 2023) and there were breaches of regulation 12 and regulation 17. We served a Warning Notice in relation to good governance. At this inspection we found the provider remained in breach of regulations.

Why we inspected

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, Effective and Well-led which contain those requirements.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. 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 Corbett House Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

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, and we will meet with provider following this report being published 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.

Corbett House Nursing Home is a residential care home providing personal and nursing care to up to 35 people. The service provides support to younger adults and older people, including people living with dementia. At the time of our inspection there were 24 people using the service.

Corbett House Nursing Home accommodates people is an adapted building, with care provided over two floors.

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

Risks to people’s health and wellbeing were not identified. Emergency healthcare was not sought for people in need of medical care. Peoples medicines were not managed safely and the guidance for their clinical needs was not always clear for staff. Care documentation was not updated and staff were not trained to meet people’s specific healthcare needs.

The provider did not have robust risk assessments and had failed to identify environmental risks to people’s safety and wellbeing. Staff were not always competent in areas related to people’s healthcare needs. Staff received induction training; however clinical competencies were not well monitored.

The provider did not have a registered manager and there was no clear leadership of the service. There were no effective governance systems in place to identify shortfalls in the quality and safety of the service. Governance systems failed to ensure people were protected from the risk of harm.

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.

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 good, (published 31 October 2019).

Why we inspected

The inspection was prompted in part by information contained within a coroner’s report which included shortfalls in management oversight of the service. Additionally, we received concerns about the management of people’s medicines, people’s healthcare needs not being met and poor recording of care documentation. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections 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.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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 Corbett House Nursing Home 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 monitor the service and will take further action if needed.

We have identified breaches in relation to people’s safety in protecting them from avoidable harm and to the quality and governance systems in place at this inspection. We found the provider was in breach of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

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 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.

We found the following examples of good practice.

¿ The provider had identified that when greeting visitors at the front door it was not possible to maintain a safe social distance, so an alternative entrance was being used.

¿ The provider had utilised an external building for visitors to wash their hands and put on their personal protective equipment (PPE) prior to entering the main building.

¿ The provider had a dedicated room to enable them to isolate people should this be required. No new admissions were accepted, should this room be occupied.

Further information is in the detailed findings below.

Corbett House is a care home that provides nursing and personal care for up to 35 people within one large adapted building. It provides care to people requiring general nursing care some of whom live with dementia and have physical disabilities. At the time of our inspection, 33 people were living at the home.

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

Staff practices to manage and administer people's covert [disguised in food and drinks] medicine required improving to ensure people’s needs and safety were fully promoted. Improvements were also required in infection control measures.

People were cared for by staff who knew how to keep them safe and protect them from abuse. The provider’s recruitment procedures were followed so people were not placed at avoidable harm by potential staff who were unsuitable to provide care. Sufficient, knowledgeable staff were available to meet people's needs. People told us when they needed assistance, staff responded promptly so people's safety needs were not compromised.

People's needs were assessed, and care was planned and provided to meet people's needs. Care was provided by staff with training and the general manager understood this needed to be provided on a regular basis. People received their medicines from trained staff whose competencies' were checked. Staff felt well supported in their roles.

People had a nutritious diet, and they enjoyed the food offered. Staff ensured people had enough to drink to meet their individual needs.

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.

Staff worked in close liaison with local health and social care services to ensure people had access to any specialist support they required.

People were complimentary about the caring nature of staff. Staff promoted people's right to make choices in every aspect of their lives and supported people’s levels of independence. People were supported with dignity and respect and end of life care was centred around each person being comfortable and pain free.

People's care and support met their needs and reflected their preferences. People had the opportunity to participate in fun and interesting things to do both on a one-to-one basis and in groups.

The general manager was committed to continual improvements within the service. This included improvements to the home environment and facilities to ensure these were suitable for people’s needs.

There was a positive and open culture which was led by the management team. A range of effective quality checks were in place to monitor the quality and safety of the service provided so people continued to receive quality care.

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 20 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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

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.

The home is registered to provide accommodation and personal care for adults who require nursing care for a maximum of 25 people. There were 24 people living at the home on the day of the inspection.

At the last inspection on 15 and 17 March 2016 the service was rated as requires improvement, this inspection was made to see if improvements had been made. Since the last inspection the manager had registered with CQC. 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.’

People told us they felt safe and well cared for. Staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe. People told us staff were available and responded when they needed care.

People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met. People were supported by staff to have their medicines when they needed them.

The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). Staff sought the consent of people before providing care and they could choose the support they received. People’s rights and freedoms were respected by staff. Staff understood people’s individual care needs and had received training so they would be able to care for people in the best way for them.

People using the service spoke positively about their care. People were supported to eat a balanced diet and with enough fluids to keep them healthy. People’s needs were met as there were good links with health and social care professionals. Where needed staff sought and acted upon the advice received.

People told us the staff were caring and respectful. People were relaxed around the staff supporting them told us they had developed good relationships with the staff. People said their privacy and dignity was maintained and our observations supported this.

People had expressed their views and gave feedback about the care so that their individual needs were met. People said staff listened to them and they felt confident they could raise any issues should the need arise.

Staff spoke highly of the management team and of the teamwork within the home. Staff were supported through supervisions, team meetings and training to provide care and support in line with people needs and wishes. The quality of the service provision and care was monitored by the provider and actions taken where required to maintain or improve the standards.

The home is registered to provide accommodation and personal care, and the treatment of disease, disorder or injury for a maximum of 25 people. There were 25 people living at the home on the day of the inspection.

Since the last inspection the registered manager had left the service and a new manager had been appointed but had not yet registered with CQC. 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.

People told us they felt safe and well cared for. Staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe. People told us staff were available when they needed care.

People said they would like more activities as there was little to do and our observations supported this. We recommend that the service seek advice and guidance from a reputable source and based on current best practice about providing meaningful activities for people with dementia.

People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met. People were supported by staff to have their medicines when they needed them.

The deputy manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). However records showed DoL applications had not been reviewed to ensure that they reflected current information. People told us that staff sought their consent before providing care and they could choose the support they received.

People’s nutritional needs were met but people felt the food they received could be improved. People told us that although there was choice, meals could be repetitive and the quality could be improved. People were supported with drinks throughout the day.

People were supported to access health care professionals and staff responded to the advice received in providing care to people.

People were involved in making decisions about their care and treatment and were encouraged to express their views and give feedback on the support they received. People said staff listened to them and they felt confident they could raise any issues should the need arise.

Staff said they were supported by the management team and the provider and the manager had implemented recent improvements. There were systems in place to check and improve the quality of the service provided and take actions where required. Some improvements had been implemented but further actions were required to ensure the changes were made in a timely way.

' Is the service safe?

' Is the service caring?

' Is the service responsive?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on the people we spoke with who used the service, the staff who supported them and from looking at records. At the time of our inspection the provider did not have a registered manager in post.

Is the service safe?

People told us they felt safe with the staff that cared for them. There were procedures in place to keep people safe. Staff understood how to safeguard the people they supported.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberties Safeguards which applies to care homes. The provider had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. This meant that people would be safeguarded as required.

Is the service effective?

People told us that their visitors were able to see them in private and that visiting times were flexible. They also told us the home were accommodating and welcoming to visitors.

It was clear from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well.

The provider was updating the care records to ensure they were person centred and reflected their care needs in detail. We found that only some of the care plans had been updated. The provider told us that they were providing time to the manager to enable them to complete this.

Is the service caring?

We spoke with three people who used the service and two relatives. We asked them for their opinions about the staff that supported them. What people told us was positive, one person said; 'Yes, its ok'. Another person said; "Very good staff".

People were supported by staff who demonstrated a clear understanding of their needs. When we spoke with staff it was clear that they genuinely cared for the people they supported.

In the care records we looked at people's preferences and interests and found that care and support had been provided in accordance with people's wishes. We saw that the care people received reflected what we read in their care records.

People were treated with respect and dignity by the staff on duty. For example we saw notices on people's bedroom doors to knock before entering as people were receiving personal care and we saw that staff respected this.

Is the service responsive?

The provider was responsive to people's needs. We saw examples where people were supported to attend hospital appointments when they were required.

People completed a range of activities within the service. People told us they were supported by staff with activities that they enjoyed.

Is the service well-led?

Staff were clear about their roles and responsibilities. They told us the manager listened to them.

The provider told us that they had recently sent out questionnaires to relatives. The provider told us that questionnaires were being written to send to people who lived in the home and the staff that worked there. This meant that the provider was taking appropriate steps to gather people's views of the running the home.

The provider had some assessing and monitoring audits in place which would identify the welfare and safety of people who used the service. The provider may wish to note that we found there were no systems in place that analysed the incidents or accidents to assess whether there had been any trends or concerns that required action. We found no evidence that the provider had learnt from any incidents that had occurred.

People were positive about life at the home. One person said: 'They (the staff) do the best they can. They (the staff) are such a cheerful lot of girls.' One family member told us: 'She seems to be a lot more settled there (Corbett House) than she was at home. They (the staff) seem quite good.'

Throughout our inspection we observed positive interactions between people who lived at the home and staff. The staff we spoke with told us about the personalised care that they provided to people. This included how staff helped people to make simple everyday decisions.

We found that people who lived at the home did not always receive appropriate stimulation to meet their diverse needs. During our inspection we saw no meaningful activities taking place or evidence of on-going planned entertainment.

We observed that one member of staff who supported one person who lived at the home to move between a wheelchair and a chair used inappropriate techniques. This practice can put people at risk of harm.

We observed how people who lived at the home were supported to take their medicines in the morning. We saw that some improvements were needed. For example to ensure that staff were not disturbed during the medicine round and the handling of medicines did not place people at risk from cross infections.

We found that staff were recruited in a safe way and correct checks were carried out to ensure their suitability to care for people.

The provider had responsive systems in place to monitor and review people's experiences and complaints. Family members that we spoke with told us that if they were not happy with the care and support their relation received they would tell the provider or staff.