Regents Court Care Home

Updated 25 January 2024

The inspection

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.

Inspection team

The inspection team consisted of 2 inspectors on all 4 visits to the home.

Service and service type

Regents Court 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. Regents Court is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to 12 people and 2 relatives about their experience of the care provided. We spoke with 3 professionals who have contact with the service. 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.

We spoke with 23 members of staff including the nominated individual, director, registered manager, supporting managers, office managers, senior care staff, care staff, housekeeping, maintenance, laundry and activities members of staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 6 people's full care plans, daily monitoring charts for 18 people, medicine administration records (MAR) for 8 people and 4 staff recruitment files. We viewed a variety of records relating to the management of the service including audit systems.

We met with the nominated individual remotely over video call and face to face to share our feedback and concerns. The nominated individual developed an action plan and shared this with us at regular intervals.

Updated 25 January 2024

About the service

Regents Court Care Home is a residential care home providing personal care to up to 40 people. The service provides support to people over the age of 65 and people living with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of the service and what we found:

We found evidence during our inspection of multiple breaches of regulation and the need for this provider to make improvements.

People were not always protected from the risk of harm; we found systems were not effective in reducing risks to people from incidents, the spread of infection or the environment. Systems in place to safeguard people from abuse were not robust and processes for learning lessons were not effective in driving improvements.

People's care plans and risk assessments were not robust to ensure safe care delivery. Care records were not always person-centred, accurate and up to date. People were not always supported to access information in an appropriate way for their needs.

Staff recruitment practices and monitoring systems were not always effective to ensure safe care delivery. Staff were not always fully trained, or their understanding and competence checked to ensure they had understood the training and applied this to their practice. Training provided for staff was not meeting their role expectations and some staff's understanding of the Mental Capacity Act (2005) and dementia was limited.

The provider's quality assurance systems and processes were not effective and had not enabled them to assess, monitor and improve the quality and safety of the service. Staff did not have regular formal supervision to receive feedback on their performance, or constructive feedback on how this might be improved. People's health appointments and outcomes were not always recorded fully or accurately. This meant there was no clear record of when people were seen by health professionals or what the outcome of their appointments or visits were.

People were not always 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 supported this practice. Systems and processes were not in place to effectively support people in the decision-making process.

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 11 January 2023). 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 the provider remained in breach of regulations.

Why we inspected

When we last inspected Regents Court Care Home on 16 & 17 November 2022, breaches of legal requirements were found. This inspection was undertaken to check whether they were now meeting the legal requirements.

During the inspection we also found there were concerns relating to how the provider had managed people’s changing needs, so we widened the scope of the inspection to become a comprehensive inspection.

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 Regents Court Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people not being treated with dignity and respect, how people's safety was managed, how people were safeguarded from abuse, people's person-centred needs and how the service was run 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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.