The Swallows Residential Care Home

Updated 11 March 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection site visit was completed by two inspectors and an Expert by Experience. The Expert by Experience made telephone calls to relatives to seek their feedback on the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Swallows Residential Care Home 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. The Swallows Residential Care Home 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. At this location, the provider and the registered manager were the same person. They have therefore been referred to as ‘the provider’ throughout this report.

Notice of inspection

This 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. 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 with 6 people who lived at The Swallows Residential Care Home to seek their reviews of their care and support. Not everyone who used the service were able to tell us about their experience of receiving the service, so observations of care and support were also made. We spoke with 11 people’s relatives and spoke with 8 staff members. These included the provider, deputy manager, office support workers, care staff and maintenance staff. We also spoke with 2 independent care consultants engaged by the provider.

A selection of records were also viewed, and these included the care plans and associated records for 3 people who used the service. The medicines records for multiple people were also reviewed. The governance records viewed included policies and procedures, staff recruitment records, training information, quality monitoring audits and maintenance/health and safety records.

Updated 11 March 2023

About the service

The Swallows Residential Care Home is a residential care home providing personal care to 12 people aged 65 and over at the time of the inspection. The service can support up to 16 people.

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

People, including those living with dementia, were not always safe and were placed at risk of harm. This was due to the condition of the environment, poor infection control processes, medication management and lack of consideration of fire safety measures at the service.

People were not always kept safe. People were at risk of harm as the provider had not identified, assessed or mitigated risks. This included risks related to people's health and care needs

The leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met. The provider had not ensured that their systems and processes were effective in enabling staff to provide safe and effective care for people.

Not all staff received training in areas relevant to people's needs including their health and safety. The provider could not evidence during the inspection that all staff completed an induction when they started work at the service. People were at risk of being supported by insufficient numbers of staff at certain times of the day.

People were not 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 did not support this practice.

Audits and checks in place had failed to identify areas of improvements we identified during this inspection.

The provider had not ensured there was adequate oversight of the service. Quality assurance systems and processes did not identify or address all of the issues found during this inspection.

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 6 July 2021) and we found a breach of Regulation 12 of the Health and Social Care Act. This was because infection control processes were not adequate. 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

We received concerns in relation to the security of the building and standards of care at the home. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 inadequate based on the findings of this inspection.

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 report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Swallows Residential Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing and good governance at this inspection. We have also made a number of recommendations about the provider seeking advice best practice in relation to dementia care, healthcare liaison and compliance with the Mental Capacity Act 2005.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

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.