25 May 2023
During an inspection looking at part of 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.