Island Court Care Home

Island Court Care Home is a care home which provides personal care with nursing for up to 55 people, including people with dementia. At the time of our inspection there were 54 people using the service.

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

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

Quality assurance systems were not always effective for people. This meant the action taken by the provider had not always ensured people received consistent, caring and safe support. People did not always experience a positive and empowering culture at Island Court Care Home.

People were not always treated in a compassionate, respectful way. Some people experienced inconsistencies in the caring nature of staff members. People were supported to practice their religion and the service considered people's cultural needs and wishes. People were supported to express their views and be involved in their care, although people didn't always feel this was effective.

People and staff didn't always feel there were enough staff, although the service monitored people's needs to assess the number of staff needed. People received their medicines safely. 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; however, the policies and systems in the service did not always support this practice. People's capacity was not always assessed and their best interests considered when it would be appropriate to do so.

People were not always supported by staff who had up to date training; this was exacerbated by several new staff members who were in the process of completing their induction. People's needs and choices were assessed and the service ensured people's dietary needs were well met. People were also supported to access healthcare and external support as needed.

People spent long periods of time without engagement. However, there was an activities coordinator and plans in place to increase support with activities. People were supported to be part of the local community. People's communication needs were considered and catered for. Systems were in place to seek feedback and resolve people's complaints.

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 19 November 2021).

Why we inspected

The inspection was prompted in part due to concerns received about the management of safeguarding incidents and the quality of internal investigations in accidents or incidents. A decision was made for use to inspect and examine those risks.

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 found evidence that the provider needs to make improvements. 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 Island Court Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to how people’s safety was managed, how people were safeguarded from abuse, their rights promoted, people being treated with dignity and respect 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.

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.

Island Court Care Home is a care home which provides personal care with nursing to mainly older people, although it also provides care to younger adults. Island Court Care Home is registered to accommodate 55 people, some of these people live with dementia. 55 people lived at the service when we visited.

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

Communication care records lacked information to ensure people who were non-verbal received care in line with their preferences.

Some care records had missing information such as frequency of repositioning for people with skin integrity issues.

Some people and their relatives were not actively involved in the development of assessments and care plans.

People's needs were assessed before they moved into the home to make sure these could be met, and it was the right place for them to live.

We found people were protected from potential abuse and avoidable harm by staff that had regular

safeguarding training and knew about the different types of abuse.

People received their medicines when they needed them, and medicines were managed safely by suitably trained staff.

Staff were recruited safely and there were enough staff to meet people's needs. Staff received on-going support, training and supervision to be effective in their roles.

The environment was clean, and staff observed and followed infection control procedures in line with national guidance for reducing the spread of COVID-19.

Staff understood the importance of ensuring people's rights were understood and respected.

People and their relatives told us they felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible.

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 spoke positively about working for the provider. They felt well supported and that they could talk to management at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

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 inadequate (published 10 December 2020) and there were multiple breaches of regulation. 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.

This service has been in Special Measures since 18 October 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

The inspection was prompted in part due to concerns received about the management of safeguarding incidents, recording processes and unsafe discharge and pre assessment practices. A decision was made for us to inspect and examine those risks.

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.

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

Island Court Care Home is a care home which provides personal care with nursing where assessed as needed to predominately older people, although it can also provide care to younger adults. The service can also accommodate people with dementia. Island Court Care Home is registered to accommodate 55 people. 35 people lived at the service when we visited.

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

We found that despite regular audits taking place, some people’s medication records, and care plans were not up to date or accurate. Audits completed by the provider were ineffective identifying issues we found during the inspection.

We found people were protected from potential abuse and avoidable harm by staff that had regular safeguarding training and knew about the different types of abuse.

We found there were sufficient numbers of staff members on duty to keep people safe. We found the provider followed good infection control practices. We observed staff members using protective clothing, gloves and aprons, during personal care to help prevent the spread of healthcare related infections.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to management at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

Staff had received an induction that provided them with the training, information and support they required to effectively and safely meet people's needs.

Rating at last inspection:

This service was registered with us on 18/02/2020. The last rating for the service under the previous provider Indigo Care Services Limited was inadequate, published on 25/12/2019. The rating under the previous provider is carried over to the new provider.

Why we inspected

We received concerns in relation to the pre-assessment processes and medicine management of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained inadequate.

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

Enforcement:

We have identified a breach in relation to governance at this inspection. The provider responded to the concerns on the day of the inspection.

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.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review.

If the service has demonstrated improvements when we inspect it again. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

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