About the service Monica Court is an extra care scheme, there are two other extra care schemes attached to this registration, Mount Carmel and Moore's House. Extra care scheme's operate in purpose-built properties, which provide accessible and safe housing for older people who are unable to live completely independently. Each person lives in their own flat but has access to a shared lounge and communal dining area. Not everyone who used the service received personal care. Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
The service had policies and procedures in place for the safe administration and use of medicines. However, these were not always followed. Medicines administration records (MARs) did not always clearly indicate if the dose of medicines administered was in line with the prescriber's instructions. People we spoke with told us they received medicines safely and on time.
Peoples records were not always up to date and we found gaps in repositioning charts and food and fluid charts, although when we reviewed people’s daily notes, we found these tasks were taking place.
Mental capacity assessments had not always been completed for individuals that may lack capacity. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Safeguarding policies and procedures were in place and staff knew how to access these. Safeguarding referrals were made when needed, however, lessons learned were not always taking place.
Peoples care records showed that risk assessments had been completed for various aspects of care but, there were no personalised COVID-19 risk assessments in place.
People told us they did not always feel the service was adequately staffed. For example, there were inadequate numbers of staff on duty at night time.
The service had adequate supplies of appropriate personal protective equipment (PPE) meaning that people were better protected against the risk of infection.
Relevant notifications were being sent to CQC for notifiable events.
Most staff told us they felt supported in their role and they enjoyed their work.
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 Good (published 16 November 2018)
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care settings even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
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. No areas of concern were identified in the other key questions. We therefore did not inspect them. 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 changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence the provider needs to make improvement. 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 full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Comfort Call - Monica Court 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 breaches in relation to good governance and staffing 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.