Ingham Old Hall Care Home

Updated 6 November 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

The inspection was carried out by one inspector.

Service and service type

Ingham Old Hall 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

This inspection was unannounced.

What we did before the inspection

Prior to the inspection we carried out a monitoring activity of the service. This included reviewing information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who worked with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We received feedback from three people who used the service, five relatives and two staff. We spoke with the registered manager. We reviewed several records relating to the running of the service including governance audits, staff training records, staff recruitment records, policies and care plans.

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 one further person who used the service and a further four members of staff including maintenance and housekeeping personnel and a senior care assistant. We observed the care people received and assessed the premises for safety and cleanliness. We observed lunch to ascertain the experience for people and ensure people’s nutritional needs were met.

We looked at medicine’s management and other care records such as care plans and repositioning charts. Surveys were viewed to ensure they met the accessible information standard.

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 spoke with two professionals who regularly visit the service.

Updated 6 November 2021

About the service

Ingham Old Hall Care Home is a residential home that provides personal care to up to 25 older people, some of whom may be living with dementia. It is a converted period building with extensive gardens. At the time of the inspection, Ingham Old Hall was home to 23 people. Although the home is registered for up to 25 people, 2 rooms are not being used meaning the home was at full capacity.

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

People told us their needs were met in a person-centred and timely manner by staff who were well-trained, kind, compassionate and caring. They 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’s needs had been assessed and accurate, person-centred care plans were in place that had been regularly reviewed. The risks to people had been identified and measures were in place to reduce them. Healthcare needs had been considered and met. People received food of their choice, in appropriate quantities and that they enjoyed. Medicines were well managed, administered safely and in line with best practice.

Good infection prevention and control measures were in place and COVID-19 had been well-managed, considered and mitigated. We saw that the home was visibly clean, and people had a choice of how they spent their day. Their rooms were personalised, and signage was in place to assist orientation.

Complaints were taken seriously and investigated and people we spoke with told us they felt listened to and involved. Staff told us they felt supported and that teamwork was effective. There was an open culture within the home and people were encouraged to speak up. Feedback on the service had been sought and the provider had worked with experts to improve the quality of the service.

People told us that improvements had been made in the service since our last inspection and this was observed and corroborated. A new registered manager had been appointed who had a good oversight of the service, had implemented action plans to address concerns and had a robust governance system in place to monitor and assess the service and continue to drive improvement. Whilst further embedding was required, we had confidence that the service would continue to improve.

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 (report published on 28 November 2019) and there were two breaches of regulation; a warning notice was served in relation to medicines management. The provider completed an action plan after the last inspection to show what they would do and by when to improve. As this inspection we found improvements had been made and the provider was no longer in breach of regulations and had been compliant with the warning notice.

Why we inspected

Prior to the inspection we carried out a monitoring review of the service. A monitoring review considers a range of information such as the current rating, any ongoing or planned regulatory activities, information about safeguarding, whistleblowing, incident reports (we call these statutory notifications), whether the service has a registered manager, feedback from people who use services and their family and friends, and other contextual information. This prompted us to carry out this inspection as evidence suggested the service had improved.

We undertook this focused inspection to check the provider now met legal requirements and where we had evidence that the service had improved from their previous rating of requires improvement. This report only covers our findings in relation to the key questions of safe, effective, responsive and well-led.

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 changed from requires improvement to good. This is based on the findings 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ingham Old Hall Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service and take action as appropriate.