Victoria House

Victoria House is a residential care home providing personal care to up to 22 people. The service provides support and rehabilitation therapies to people with sensory impairment or a physical disability resulting from an acquired brain injury. At the time of our inspection there were 22 people using the service.

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

We found the provider had made and sustained improvements since our last inspection. People we spoke with gave positive feedback about the service.

Staff continued to support people well with personal care and activities of daily living. The provider had built multi-disciplinary teams with the necessary specialists to support people with the rehabilitation therapies people needed.

The provider had made the necessary improvements to make sure people would be kept safe in the event of a fire. The provider continued to protect people against other risks, such as risks of abuse or avoidable harm.

The registered manager had made and embedded improvements in how the service was managed. 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 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 7 July 2022)

Why we inspected

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

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 good based on the findings of this inspection.

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

Follow up

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

Victoria House is a residential care home providing personal care to up to 22 people. The service provides support and rehabilitation therapies to people with a physical disability or sensory impairment as a result of an acquired brain injury. At the time of our inspection there were 19 people using the service.

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

People we spoke with were positive about the service. One person said, "I really like it here. it is very, very good." Another person told us the service was well managed with motivated staff. A relative who had some concerns about aspects of the care still said, "It’s a good place. There are some very good people working there."

We found staff supported people well with personal care and activities of daily living. However, there were insufficient in-house specialists to deliver the standard of rehabilitation therapies indicated by their assessments.

We identified necessary improvements to ensure people were kept safe in the event of a fire. People were protected against other risks, including risks of abuse and avoidable harm. There were processes in place to manage medicines safely. The provider had processes to respond to and learn from incidents and accidents.

People's care and support were effective. 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. People's rights were protected if they lacked capacity to make decisions and were at risk of being deprived of their liberty. Staff had appropriate training. People reported that meals were "excellent".

People's care and support were caring. Staff supported people with kindness and compassion. They respected people's dignity, privacy and independence. Where it was possible, staff involved people in decisions about their care and support.

People's care and support took into account their need for social inclusion and any communication needs arising from disability or impairment caused by acquired brain injury. Following the COVID-19 lockdown, staff had identified individual things people wanted to do outside the home, and had started to enable these.

There had been a period of inconsistent leadership at the home which had affected staff morale and the availability of therapies people needed. A new manager was in post who had started to make improvements. People we spoke with and staff were optimistic the new manager could make the required improvements.

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

The last rating for this service was good (published 5 March 2020). Since we awarded this rating, the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

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.

Follow up

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

We found the following examples of good practice.

The provider worked within government guidance to support family visits in line with people’s person-centred care needs. When more strict precautions were needed for safe visiting during the pandemic, the provider had made suitable arrangements such as facilities for garden visits.

The registered manager reported no impact on people’s care because of sector workforce challenges. They had maintained staffing levels through the use of suitable agency staff. They had recruited new staff who were due to start work shortly after our inspection.

The provider had made use of the available space in the home to support people and visitors to keep safe distances when required. Some rooms had both en suite bathrooms and small private kitchens which would make it easier for people to isolate if necessary.

The provider maintained high standards of hygiene, cleanliness, and maintenance. An internal infection control audit had identified improvements to facilities for staff to put on personal protective equipment (PPE) safely, and new PPE stations had been ordered. The registered manager took and followed advice from both the provider’s organisation and local health and social care partners, particularly around safe visiting in exceptional circumstances.

We found the following examples of good practice.

The provider had acted to make sure people could have visitors safely. There had been a temporary gazebo in the garden during the summer, good use of the outdoor space, and video conferences for families who could not visit physically. The provider planned to use part of the building for visits during the winter once Perspex screens were in place, with suitable use of PPE, social distancing and cleaning protocols in place.

The provider had anticipated guidance and acted proactively to keep people safe. For example, they had started a home lock down before this was included in government guidance. This had reduced the risk of COVID-19 entering the home. They supported people to understand the changes with visual posters and Easy Read leaflets.

The provider was able to use multiple separate zones with their own lounge area to improve isolation. They had also swapped the gym and dining areas to enable better social distancing.

The provider had acted to make sure new standards of hygiene and cleanliness could be maintained. They had used appropriate cleaning products, and robust cleaning checklists, processes and audits were in place to meet the new standards.

The staff team had responded positively to the new infection prevention and control procedures. The provider had kept the home free of COVID-19 at the time of our visit.

Further information is in the detailed findings below.