Proctor Residential Care Home Limited

Updated 8 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was announced and was undertaken by one adult social care inspector. We gave the provider 24 hours’ notice of the inspection because we wanted key people to be available.

Prior to the inspection, we looked at the information we had received about the service since the last inspection. This included notifications. Notifications are information about specific important events the service is legally required to report to us. We also looked at the action plans the provider sent to us after the last inspection in December 2016. This plan told us about the action they planned to take to address the improvements we asked them to make. We had not asked the provider to complete their Provider Information Record (PIR) prior to this inspection.

During our inspection we spoke with four people who lived at Proctor. People responded in varying degrees when we asked them to tell us about their experience of living in Proctor Residential Care Home. This was because of their enduring mental health conditions. We spoke mainly with the assistant manager and only briefly with the registered manager because of other commitments they already had planned. We also spoke with two staff members.

We looked at the five people’s care files and other records relating to their care. We looked at three staff employment records to check recruitment procedures and checked staff supervision and training arrangements. We looked at key policies and procedures, the audits completed to ensure the quality and safety of the service was maintained. We looked through the minutes of the meetings with the staff team.

We received feedback from two health or social care professionals. We asked them to tell us their views and experience of the care and support people received. The feedback has been included in the main body of the report.

Updated 8 March 2018

This inspection took place on 19 and 25 January 2018 and was announced. We gave the service 24 hours’ notice of the inspection because we wanted people to be available to talk to. The service is registered to provide accommodation and personal care for up to five people with enduring mental health conditions. At the time of the inspection there were five people in residence but one person was in hospital.

There was a registered manager in post. 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.

At the inspection in December 2016 we found improvements were required in practices around infection control and auditing the quality and safety of the services provided. Following the inspection the provider sent us an action plan about how they would address this and with set timescales. We found at this inspection things had improved and the overall rating had changed from requires improvement to Good.

People were safe. The staff team had received safeguarding adults training and knew what to look out for. The staff were aware of their responsibility to keep people safe, to liaise with community facilities used by people, and also how to maintain their own safety.

Risk assessments were completed for each person and ensured where risks were identified there were plans in place to reduce or eliminate the risk. There was a culture of learning following any accidents and incidents. Regular checks on the premises were undertaken to ensure the home and facilities were safe. Checks were also made of the fire safety systems, the hot and cold water temperatures and equipment to make sure they were safe for staff and people to use. Any repairs were attended to in a timely manner.

People were looked after by a small staff team, they had worked at the home for many years. Staffing levels were based upon the needs of the five people who resided in the service. The service had not recruited any new staff but would follow safe staff recruitment procedures to ensure they employed the right staff. The appropriate measures were in place to protect people from being harmed.

The management of medicines was safe. Staff who supported people with their medicines had received training and weekly stock checks of medicine supplies were undertaken. The measures in place to prevent the spread of any infection had improved so that people were protected from the risks of cross infection. However we have suggested checks on the bed mattresses be added to the infection control audit process.

The service was effective. People’s care and support needs were assessed to ensure the way they were looked after was effective. There was training programme for the staff team to complete and training was refreshed to ensure the staff had the necessary skills and knowledge to care for people correctly. The training programme included the Mental Capacity Act 2005 and the service worked within the principles of this. People were always asked to consent before receiving any support. The staff team were well supported by the registered and assistant manager and their work performance was monitored.

People were provided with sufficient food and drink and the staff team took account of their likes and dislikes in respect of food and drink. The staff took the appropriate action where people were at risk of losing weight. There were good arrangements in place to ensure people saw their psychiatrist, GP or other healthcare professionals as and when needed.

The service was caring. Staff knew the people they were looking after well and spoke respectfully about them. People were prompted and encouraged to maintain good personal hygiene, and to change their clothing regularly, although at times this was not achieved. The staff team used accessible communication methods in order to let people know important facts. People were encouraged to express their views of the service and be involved in making decisions or agreements about their care and support.

The service was responsive to people’s individual care and support needs. The care and support people received was adjusted when their care needs changed. There were good assessment and care planning arrangements in place, which meant people were provided with a person centred service that met their own care and support needs.

The service was well led. The staff team was led by a registered manager and an assistant manager, who provided good leadership and support. The registered provider had a regular programme of audits in place, which ensured that the quality and safety of the service was checked. These checks were completed on a daily, weekly or monthly basis.