Portway House

Updated 31 January 2023

Inspection team

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 was carried out by 2 inspectors and an assistant inspector.

Service and service type

Portway House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

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

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. 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 also used information gathered as part of monitoring activity that took place on 19 July 2022 to help plan the inspection and inform our judgements.

We used all of this information to plan our inspection.

During the inspection

Inspection activity started on 15 November 2022 and ended on 23 November 2022. We visited the service on 15 November 2022, which was unannounced and returned on 17 November 2022, as agreed in advance with the registered manager. 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 6 people who used the service and 12 relatives about their experience of the care provided. We spoke with 12 staff members which included the registered manager, nominated individual, deputy manager, nurses, senior care assistants, care assistants, office manager, head cook, head of housekeeping and the activity co-ordinator. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also gained feedback from two health professionals who support people living in the service.

We reviewed a range of documents and records for 15 people, this included care plans, risk assessments, daily notes and medicine records. We looked at 8 staff recruitment files and training records. We also looked at records, systems and processes related to the management and quality assurance of the service.

Updated 31 January 2023

About the service

Portway House is a residential care home providing personal and nursing care and accommodation for up to 48 people. This includes both younger and older people with physical and sensory impairments. The service was supporting 46 people at the time of the inspection. Portway House has three floors. The ground floor is used for people with an acquired brain injury and for people who move into the home for a period of rehabilitation.

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

During our inspection we observed staff members carrying out unsafe moving and transferring practices. This was immediately brought to the registered manager’s attention, who addressed these concerns and took appropriate action to ensure people were supported safely.

The provider had systems in place to monitor the quality and safety within the service. However, these needed some improvement as they had not highlighted the issues we found, for example; concerns about people’s care records and infection control practices.

We observed some infection control concerns such as; foot operated pedal bins not working, the registered manager advised us that this would have been identified during their daily checks which had not taken place due to the inspection; equipment had not being thoroughly cleaned, and two staff were observed not wearing face masks in accordance with national guidance. We also found some unlabelled and out of date food in communal areas. These issues were immediately addressed by the registered manager at the time of the inspection.

The management of medicines required improvement as guidance for staff to follow was not always clear and safe practices were not always followed.

People were supported to maintain links with loved ones via video and telephone calls. People had access to a variety of in-house activities to engage in. Although staff knew people well and how to meet their needs, this was not always supported by the daily records completed by staff members following the activity. The concerns we identified with the lack of information around people’s interests in care plans, risk assessments and daily notes, during the inspection were immediately addressed by the registered manager.

People were supported by staff who were trained and knowledgeable about how to identity and minimise risks to their safety and wellbeing.

People and relatives knew how to raise concerns and most felt confident any issues would be addressed. Staff felt supported in their role and described the management team as approachable, kind and responsive.

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 information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

At our last inspection we found a breach of Regulation 17 Good governance. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.

At this inspection, we found the provider remained in breach of regulation 17.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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 found a continued breach of regulation 17 good governance at this inspection.

Please see the action we have told the provider to take at the end of the full version 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.