Underhill House Residential Home

Updated 14 February 2020

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.

Inspection team

The inspection team consisted of one inspector and one assistant inspector.

Service and service type

Underhill House 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 five people who used the service and four relatives about their experience of the care provided. We spoke with seven members of staff including the provider who was also the registered manager, deputy manager, care workers, housekeeping staff and the chef. 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 three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment, training, and staff supervision. A variety of records relating to the management of the service, including complaints, safeguarding, audits and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at further evidence we requested from the registered manager. We spoke with two professionals who regularly visited the service. We also received feedback from three relatives and four staff.

Updated 14 February 2020

Underhill House Residential Care Home (hereafter referred to as Underhill House) is a residential care home in the coastal city of Plymouth, providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 28 people. The service is in a large adapted house set over three floors with three lounges and two dining spaces.

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

People told us they felt safe, relatives said they felt happy their relatives were being well supported and cared for. Where risks had presented themselves these had been assessed, reviewed, and appropriate action was being taken to mitigate them. The building was checked regularly in terms of fire and other environmental factors.

There were enough staff to meet the needs of people at different times of the day. These staff were recruited safely, using a robust process. People and relatives told us the service was always very clean and smelled fresh.

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 had choices over what they ate and drank, where they sat, and how they spent their time. The service arranged for local entertainers to come in but also catered for quieter tastes.

Staff were kind and caring and the service had a homely feel. People were treated with dignity and respect and their families welcomed whenever they visited.

People accessed healthcare services where needed and professionals we spoke with had a positive view of the service. There was an emphasis on putting people first and making sure they were happy and well. Care plans included information about people’s life histories and what care and support they needed from staff.

The service was well-led. Aspects of the running of the service were regularly audited and there was a good understanding of regulatory requirements, including the need to be open and honest when things went wrong. There was an open culture where staff felt supported through supervisions, training, and the open-door policy of the management team.

We made one recommendation that signage in the service was reviewed to ensure it met the needs of people living in the service.

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 2 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.