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Inspection Summary


Overall summary & rating

Good

Updated 7 March 2019

Mr ‘C’s is a ‘care home’, operated by Woodland Healthcare Limited. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Mr ‘C’s is currently registered to provide accommodation for people requiring both nursing and personal care. However, during 2018 the service began making changes and has ceased providing nursing care for a trial period. People who needed nursing care left the service and so the service no longer had registered nurses working at the service at the time of the inspection. Any nursing needs people may develop were met by the community nursing teams. At the time of the inspection 28 people were living at the service, some on a permanent basis, others were there for short stay respite care, or intermediate care between a period of hospital care and returning home.,

People living at Mr ‘C’s were mainly older people, most living with physical health conditions associated with older age, or mental ill health. Some people had limited care needs but were awaiting changes to their accommodation or needing support during the ill health of their carer. The service accommodates up to 40 people in one adapted building, set over four floors, but we were told they were not intending to take over 29 people at the present time.

At the last inspection in August 2017, Mr ‘C’s was rated as requires improvement overall and in the key questions of safe and well led. Key questions for effective, caring and responsive were rated as good.

On this inspection we have rated the service as good overall, but with requires improvement in the key question of safe. This was because we identified some areas of concern about the medicines systems in use and the management of urinary catheters. Between the inspection visits the service changed the way they managed medicines. We have recommended they arrange for an early audit of the new systems to ensure they meet safe standards and good practice. We also saw the service had taken immediate action in the meantime to reduce risks.

The home had a registered manager. 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. Since the last inspection the service’s management structure had been strengthened by the appointment of two managers at the service - one looking at the management of the environment and the other looking at people’s care. People living at the service and staff were clear about who was ‘in charge’, and told us they were approachable and supportive.

Systems were being operated to assess, monitor and improve the quality and safety of the services provided, and mitigate the risks to people from their care or the environment. Assessments including those provided through the trusted assessor scheme or intermediate care professionals identified risks to people and how they could be reduced. For example, from skin damage, long term health conditions or choking. Staff were aware of the principles of safeguarding people from abuse and how to report concerns about people’s well-being.

Mr ‘C’s was continuing to develop the services and care provided. Some people stayed at the service for only 24 hours, while others were there for longer periods of intermediate care following a hospital admission. Advice on good practice was sought and visiting professionals including those from the intermediate care team told us the service communicated with them well, and followed their advice to support people’s needs. We heard examples of where people had improved and returned home following a supported stay at the service.

People were supporte

Inspection areas

Safe

Requires improvement

Updated 7 March 2019

The service was not always safe.

Medicines practice was not consistently safe, and some prescribing practice had not been clear. We have made a recommendation about auditing medicines practice.

Risks associated with people’s care and the management of long term health conditions were assessed, and actions taken to mitigate risks.

Good practice in relation to the management of urinary catheters was not well understood by all staff. We have made a recommendation about this.

People lived in a safe environment.

Enough safely recruited staff were on duty to meet people’s needs.

Effective

Good

Updated 7 March 2019

The service remained effective.

Caring

Good

Updated 7 March 2019

The service remained caring.

Responsive

Good

Updated 7 March 2019

The service remained responsive.

Well-led

Good

Updated 7 March 2019

The service was well led.

The service’s management structure had been strengthened since the last inspection and roles were well understood.

People’s views on the service were sought and acted upon. We have made a recommendation about improving this communication.

People benefited because audits were being carried out and regular monitoring systems were in place from staff wellbeing to the foods served to people.

Notifications had been made as required to the Care Quality Commission about events at the service.