Archived: Inglewood Care Home

Updated 10 July 2020

The inspection

This was a targeted inspection to follow up on specific concerns we had about people living at the home. Concerns had been shared with us about the management of risk at the home, particularly in relation to nutrition and hydration.

Inspection team

Two inspectors carried out this inspection.

Service and service type

Inglewood 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 did not have a manager registered with the Care Quality Commission. This is someone who, along with the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

A manager had not been in post since 19 May 2020. An operations manager and peripatetic manager were overseeing the management of the home. The provider was recruiting for a manager at the time of inspection.

Notice of inspection

We gave a short period of notice of the inspection. This supported the home and us to manage any potential risks associated with COVID-19.

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 via a serious concerns protocol forum. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with two relatives face to face and 10 relatives over the telephone. We spoke with five staff face to face and nine staff over the telephone. This included the nominated individual, an operations manager, two nurses, five care workers, three domestic staff, a chef and a member of the kitchen team. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and a variety of records relating to the quality of the home.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 10 July 2020

About the service: Inglewood care home is a care home for up to 48 people aged 65 and over who require nursing or residential care. At the time of inspection, 31 people were using the service.

People’s experience of using this service and what we found: People and their relatives told us they were happy with the care and support which they received. They told us the overall quality of the service had improved and spoke highly of the interim manager. Staff were supported in their roles and were committed to working at the service.

There were gaps in some of the maintenance records reviewed. The number of accidents and incidents had reduced. Staff lacked confidence in managing incidents and felt that further training was needed. Safeguarding alerts had been raised when needed and appropriate action had been taken by the provider and interim manager. Some staff had limited knowledge in the application of safeguarding. There was evidence that lessons had been learned since the last inspection and following safeguarding incidents.

Quality assurance measures had been completed more robustly and action plans were in place. Staff were committed to the improvements put in place and understood time was needed to embed the improvements. Feedback was sought and used to promote change. Everyone spoken with told us significant improvements had taken place at the service and felt that this had positively impacted on the overall care which people received.

Good processes were in place to safely recruit staff. There were enough staff on duty. Medicines were safely managed, and action plans were in place to make continued improvements. The service was clean and tidy.

Improvements had been made to the assessment process. Staff were supported in their roles. Supervision and appraisals were more routinely carried out. Training was up to date.

People received a diet in-line with their needs. Robust monitoring was in line for people at risk of malnutrition and dehydration. Records for monitoring weight and dietary intake had significantly improved.

Staff were responsive when people’s needs changed. Referrals to health professionals for additional support had been carried out when needed. Significant improvements had been made to the environment, with further planned improvements in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Although people were given choice and staff sought people’s consent, some staff knowledge of the Mental Capacity Act and people subject to Deprivation of Liberty Safeguards was limited.

Staff treated people and their relatives with kindness and respect. Staff knew people well and included people into all aspects of their care. People’s privacy and dignity was always maintained. All staff worked together as a team to deliver good care to people. Relatives were made welcome and kept informed.

People received the care which they needed and told us they were happy with the care provided. Care records were significantly improved. Staff were up to date with people’s care needs and communicated with each other when people’s needs changed. People, relatives and staff spoke highly of the new activities for people.

Everyone knew how to raise a complaint if they needed to and told us the interim manager was approachable and felt able to raise a concern with them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The overall rating was Requires Improvement, (Published 25 December 2018). This was the third consecutive time the service had been rated Requires Improvement.

At the last inspection we identified breaches in relation to safe care and treatment, respecting and maintaining people’s dignity, nutrition, the premises, quality assurance, staffing levels and support for staff by way of supervision, appraisal and training. We issued a notice of decision to restrict admissions to the service without the consent of the Commission. We met with the provider to discuss the improvements they planned to make, and we asked them to provide an update each month by way of an action plan which they did.

Why we inspected: This was a planned comprehensive inspection based on the previous rating. Following the last inspection, the provider sent us action plans outlining how they intended to improve the service. We carried out this inspection to monitor the improvements.

Follow up: We will continue to monitor the service through the information we receive and discussions with partner agencies.