Premier Court Care Home

Updated 20 May 2021

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 Care Act 2014.

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

This inspection was undertaken by one inspector.

Service and service type

Premier Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was applying to be registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider had not been asked to send us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We spoke with eight members of staff including the manager, the regional support manager, the clinical lead, head of housekeeping, the chef and care workers.

We reviewed a range of records. This included two people’s care records and a random sample of medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management and governance of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from five relatives and five staff members by telephone and liaised with health professionals and local authority commissioning teams.

Updated 20 May 2021

Premier Court Care Home is a purpose-built residential care home providing personal and nursing care to 37 people at the time of the inspection. The service can support up to 59 people.

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

At the last inspection of this service the provider had failed to ensure people were protected from the risk of harm. At this inspection we found that improvements had been made. Regular checks were made to help ensure staff worked in accordance with training and health and safety guidance. Systems in place to promote people’s safety and wellbeing included checking pressure mattress settings were correct, reporting and investigating of unexplained injuries, oxygen safety and choking risks.

The provider’s quality monitoring systems were not always being effectively used at Premier Court Care Home to drive forward improvements in areas such as environment, staff feedback and some aspects of care provision. Concerns raised by staff in a 2020 survey had not been addressed, shortfalls in the environment had not been escalated for action.

The service has experienced instability at manager level for the past two years. This has not had a positive effect on the staff team who feel their confidence and trust in the support provided has declined. The staff team report low morale.

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 appeared safe and contented living at Premier Court Care Home. There were enough staff, safely recruited, to ensure people’s needs were met in a timely way. People and relatives praised staff for being kind and caring. Pleasant and appropriate interactions were observed between staff and people.

Staff clearly described how they could report any concerns internally to the management team and externally to local safeguarding authorities. Staff were supported through regular training, supervision and appraisals to provide safe care. Their skills and knowledge were regularly reviewed through competency assessments carried out by the nursing staff

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 09 November 2019) and there was a breach 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 enough improvement had been made and the provider was no longer in breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 15 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Premier Court Care Home on our website at www.cqc.org.uk.

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 have identified a breach in relation to quality monitoring and management of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.