Swan Court

Updated 23 April 2022

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

The inspection was carried out by two inspectors.

Swan court 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 registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because some of the people using the service would need support to prepare for our visit.

What we did before the inspection

We reviewed information we had received since the last inspection. We sought feedback from the local authority and Clinical Commissioning Groups. We used the information the provider sent 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 seven members of staff, including a senior manager, the registered manager, the deputy manager and care staff.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records related to protecting people from harm as well as systems used to monitor quality of care were reviewed.

After the inspection –

We spoke with four relatives about their experience of the care provided. We spoke with five care staff. We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records and further records related to people’s care.

Updated 23 April 2022

About the service

Swan Court is a residential care home providing personal and nursing care for up to eight people with a learning disability. There were five people living there at the at the time of our visit. Swan court accommodates people in one adapted building, they have their own apartments as well as shared communal spaces.

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

Infection prevention procedures were in place but there were some concerns around the monitoring of staff COVID-19 testing and how some staff refusals to be tested were being managed. Staff were recruited safely, and medicines were managed safely. Relatives told us that they felt their loved ones were safe.

Quality assurance checks were in place but had not identified some of the concerns raised during the inspection. The management were responsive to concerns highlighted and some changes were made immediately. Staff and relatives spoke highly of the new registered manager and the deputy manager. Relatives gave mixed views on the outcomes for their loved ones. Most told us they were happy with the care people received. One person told us; “I know that [my relative] is happy, I ask if [they] are happy and [they] say “yes I am happy, I want to stay here.” Another relative told us their loved one had made slow progress and may be bored at times but felt that improvements had begun since the new registered manager had joined the service.

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; most of the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human

rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people

using services lead confident, inclusive and empowered lives

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 February 12, 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to infection control and about people’s care. As a result, 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.

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.

We have found evidence that the provider needs to make improvements. 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. Although we found risk management around staff testing for Covid-19 to protect people from harm was not robust, at the time of inspection there had been no significant impact on people from this risk.

The overall rating for the service remains 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 Swan 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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to governance systems for infection prevention risks at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.