Upton House

Updated 16 May 2023

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 Health and Social Care Act 2008.

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

This inspection was completed by 2 inspectors.

Service and service type

Upton House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Upton House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people and 3 relatives about their experience of the service. We observed staff interactions with people in the communal areas. We spoke with 5 staff including the registered manager, provider's personal assistant and 3 care staff.

We reviewed a range of records. This included 4 care plans and medication records. We looked at 3 staff records in relation to recruitment. A variety of records relating to the management of the service including checks and audits.

Updated 16 May 2023

About the service

Upton House is a residential care home providing personal care to up to 20 older people. The service provides support to people living with dementia in one large, adapted building. At the time of our inspection there were 17 people using the service.

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

People told us they were happy living at the service and felt safe. Since the last inspection, the provider had appointed a new registered manager and external consultant to drive improvement. This had been successful, and improvements had been made though further improvements were still needed.

Potential risks to people’s health and welfare had been assessed, but there was not always detailed guidance for staff to mitigate the risks. Medicines were not always managed safely, improvement was still needed to make sure records were accurate. There was now a system in place to complete checks and audits on the quality of the service. However, this was still being embedded and had not been consistent in identifying shortfalls found at this inspection.

The culture within the service had changed. Relatives told us they could now visit when they wanted and visit people in their rooms. They confirmed the culture within the service was now open and transparent, they had been invited to meetings to discuss what was happening within the service.

There were enough staff to meet people’s needs, who had been recruited safely. The registered manager understood their responsibility to report incidents to the local safeguarding authority and work with them to keep people safe.

People, relatives, and staff had been asked their opinion on the service, the responses had not been analysed to identify what action was required.

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.

Rating at last inspection and update

The last rating for this service was inadequate (published 15 October 2022) and there were breaches of regulation. At this inspection we found improvements had been made, but the further improvements were required, and the provider was still in breach of regulations.

This service has been in Special Measures since 14 October 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced focused inspection of this service on 4 August 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding people from abuse and improper treatment, fir and proper person employed and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. We have found evidence that the provider needs to make further improvements and remained in breach of regulations.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. 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 Upton House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to medicines and risk management and monitoring the quality of the service 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.