Covent House

Updated 16 August 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

The inspection was carried out by 4 inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Covent 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. Covent House is a care home with 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.

Inspection activity started on 25 May 2023 and ended on 30 May 2023. We visited the service on 25 May 2023 and 30 May 2023.

What we did before the 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. 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

During the inspection we spoke with 10 people who used the service about their experience of the care provided and 23 relatives. We spoke with 14 members of staff including the Nominated individual, the head of compliance, the registered manager, 2 nurses, 7 care workers including 2 senior care workers, 1 domestic member of staff and 1 activities co-ordinator. We received feedback from 5 health and social care professionals. 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 6 people’s care records and multiple medicines records. We looked at 5 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training information and policies and procedures were reviewed.

Updated 16 August 2023

About the service

Covent House is a care home providing accommodation and personal and nursing care to up to 63 older people, including people who may live with dementia, or a dementia related condition. At the time of our inspection there were 58 people using the service accommodated in a purpose built building.

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

Improvements were required to records to ensure people received effective and person-centred care from all staff members. People’s medicines were not always well-managed.

A quality assurance system was in place, but it needed to become more robust to assess the standards of care in the service. We identified shortfalls with medicines management, care records, people’s involvement, accident, incident analysis, staff deployment, aspects of clinical care. These shortfalls had not all been identified or actioned in a timely manner by the provider’s governance system.

People and relatives were complimentary about the care provided by staff. They trusted the staff who supported them. They said staff were kind, caring and supportive of people and their families. Comments included, “We are 100% happy with the care [Name] receives” and “[Name] is always clean and tidy, their clothes are always pressed and put in the wardrobe, the way [Name] smiles when the staff talk to them is amazing.”

Staff received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe. The service was following safe infection prevention and control procedures to keep people safe.

Staffing capacity was sufficient and staff deployment was mostly effective to ensure people's needs were met in a safe, timely way. A person told us, “The staff are all lovely, I like all of them. They come quickly if I ring the buzzer.”

People received a variety of food and drink to meet their needs and any specialist diets were catered for. Staff knew people well but people were not always consulted or involved in daily decision making.

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.

Staff recruitment was carried out safely and effectively. There was evidence of collaborative working and communication with other professionals to help meet people's needs.

People's diversity as unique individuals with their own needs was respected by staff. The staff team provided support discreetly and with compassion. People’s privacy was respected, and people were supported to maintain contact with relatives.

There was a cheerful atmosphere at the service. Staff spoke positively about working at the home and the people they cared for. Several staff had worked at the home for some years. Staff and relatives said the manager was very approachable and they were supported in their role. A relative told us, “The registered manager and her staff are doing a wonderful job.”

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 13 February 2020).

Why we inspected

The inspection was prompted due to concerns received about people’s care. A decision was made for us to carry out an inspection and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see all domains of this full report.

We have found evidence that the provider needs to make some improvements. Please see the safe, effective, responsive and well-led sections of this full report.

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 see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified a breach in relation to good governance and record keeping at this inspection.

We have made recommendations about medicines management, nutrition and hydration, and promoting the involvement of people who may live with dementia, in decision making about their food and drink.

Please see the action we have told the provider to take at the end of this report.

Follow up

We have requested an action plan from the provider to understand what they will do to improve the standards of quality.