Andrews Court Care Home

We found the following examples of good practice.

The provider had staff who were trained and skilled to ensure people were admitted safely and continued to be supported in the service in accordance with national guidance. Infection prevention and control (IPC) policies and procedures were kept under review. We found safe processes were in place.

The registered manager was facilitating safe visiting in line with government guidance. One person said, “It is a lovely home and they all take hygiene and cleanliness of the building seriously.” All staff we spoke with confirmed the management team were strict when it came to wearing the right protective equipment to ensure the people were protected from infection.

During our visit we observed the staff using Personal Protective Equipment, (PPE) safely. The registered manager told us sufficient stocks of PPE were available and we confirmed this on the visit. Staff spoken with confirmed they were not short of PPE. We observed staff wore PPE appropriately in all areas of the home. One staff member said, “We have never not complied to the rules as long as I have been here.”

The home was clean and hygienic. Cleaning schedules were in place and PPE stations located on each floor with regular checks carried out to ensure the home was kept clean. One member of the domestic staff said, “We follow the cleaning schedules to make sure things are done correctly and have an audit line to follow.”

Andrews Court Care Home is a residential care home providing personal care to 34 people aged 65 and over at the time of the inspection. The care home is in a converted church and can accommodate up to 35 people on two floors.

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

People told us they felt safe and well cared for in Andrews Court Care Home. However, we found staff had not always been safely recruited, important checks regarding the environment had not been completed since July 2020 and medicines were not always managed safely. Our findings showed the provider’s systems for monitoring the quality of the service had not been effective.

Staff had completed training in safeguarding and knew the correct action to take to keep people safe. The manager used handovers and staff meetings to share any learning from incidents or accidents. Staffing levels were sufficient to ensure people had their needs met in a timely way.

The home did not have a registered manager. There was a manager responsible for running the home, but the provider had failed to ensure they had applied to register with CQC in a timely manner. The manager demonstrated a commitment to addressing our findings during the inspection. They had worked hard to ensure the home was Covid 19 secure and our inspection confirmed staff followed safe infection control practices.

Staff told us they enjoyed working in the home and found the manager to be approachable and always willing to listen to them. People who lived in the home also gave us positive feedback about the manager and told us they would be confident to approach them if they had any concerns about their care.

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 January 2018)

Why we inspected

This inspection was prompted following a number of safeguarding alerts raised with the local authority and whistleblowing concerns raised with CQC during the pandemic. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe, as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We identified breaches of regulations in relation to the recruitment of staff, the administration of medicines, the safety of the premises and the processes to monitor the quality and safety of the service.

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 Andrews Court Care Home on our website at www.cqc.org.uk.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Andrews Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is in a converted church and accommodates up to 35 people on two floors. At the time of the inspection there were 31 people accommodated in the home.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported by staff who were highly caring and compassionate. Staff knew people and their backgrounds well and used this knowledge to communicate effectively with people to ensure their diverse needs were met. Staff told us the philosophy of the home was that people should be treated as valued individuals.

People were treated with the utmost respect at all times. Staff protected their privacy, involved them in decisions about their care and promoted their independence. People described a strength of the service was the way staff cared for relatives as well as the person who actually lived in Andrews Court. All the feedback we received and saw was extremely positive about the care provided by Andrews Court.

There were enough staff deployed to meet people’s needs. Recruitment procedures helped ensure only suitable staff were employed. Staff knew the correct action to take to protect people from the risk of abuse and avoidable harm. All the people we spoke with told us they felt safe in Andrews Court.

We identified some improvements needed to be made to the way medicines were handled in the service, including the administration of prescribed creams. However, all of the people we spoke with told us they always received their medicines as prescribed. Before the end of the inspection, the registered manager had taken action to address all the shortfalls we identified.

People were cared for in a safe, clean environment. The signage and décor in the home helped to promote the independence of people living with a dementia.

Arrangements were in place to check that fire safety equipment was in working order. However, we found no fire drills had taken place since the service opened; this meant staff might not be aware of the correct action to take should the building need to be evacuated.

Appropriate Deprivation of Liberty Safeguard (DOLS) applications had been made to the local authority and people's mental capacity to make their own decisions had been assessed and recorded in line the requirements of the Mental Capacity Act 2005. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

A comprehensive assessment was completed by the registered manager before people moved in to Andrews Court. This assessment was used to formulate plans of care for each individual that were sufficiently detailed to ensure they were at the centre of their care. People’s care and support needs were kept under review and, where appropriate, they were involved in decisions about their care. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs changed.

Staff told us they received the support they required to deliver effective care. Staff had received training in a range of topics and were able to discuss their learning and development needs in regular supervision sessions.

People told us they enjoyed the meals they received. They were provided with a nutritionally balanced diet that catered for their dietary needs and preferences.

A range of activities was provided, both on a group and individual basis. These were aimed at promoting the health and well-being of people who lived in the home.

People were encouraged to comment on the care they received. They told us staff always provided the care they needed and wanted. The people we spoke with told us they were aware of how to raise a complaint and were confident the registered manager would take seriously any concerns they raised.

All the people spoken with during the inspection told us they felt the home was well-led. There was a clear management structure in place. All staff understood their roles, were highly motivated and worked well as a team. Staff told us they were treated fairly and encouraged to express their views about how the service could be improved.

Systems were in place to monitor the quality and safety of the service; these helped to ensure people received a good service that supported their health, welfare and well-being. The registered manager demonstrated a drive for continuous improvement in the service.