Archived: Swan House

Updated 10 March 2020

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

This inspection was carried out by one inspector and a specialist advisor (who was a qualified nurse) on 20 January and just the inspector returned on 22 and 23 January 2020 to complete the inspection.

Service and service type

Swan 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

The inspection was unannounced on the first day with an announced visit on the second and third day.

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. 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.

During the inspection

We spoke with 12 people who used the service and seven relatives to ask about their experience of the care provided. We used a range of different methods to help us understand people's experiences. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas. 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 spoke with eight members of staff, including care staff, nursing staff, the registered manager and provider representative.

We reviewed a range of records. This included six people's care records and four medicine records. We also reviewed the process used for staff recruitment, records in relation to training and supervision, records relating to the management of the home and a range of policies and procedures developed and implemented by the provider.

Updated 10 March 2020

About the service

Swan House is a care home registered to provide personal and nursing care for up to 45 people living in one purpose-built building, divided into two separate units. The home accommodates people living with dementia at different stages in its progression and people living with a range of complex health care needs. At the time of our inspection there was 40 people living at the home.

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

Risks were not consistently managed, and systems and processes were not always effective for mitigating ongoing risk to people. The providers quality assurance system had not always identified where improvements were needed or where improvements had been identified action on these was not always timely.

People said they felt safe and were comfortable around staff. Relatives told us they felt their family members were safe. Many people and relatives told us that more staff was needed to meet their needs.

Staff knew people needs and demonstrated a good understanding of the level of assistance people required. Staff were observed to be kind and caring. Staff spoke to people with dignity and respect and took the time to support and encourage people.

Staff received the training they needed so they had the skills and knowledge to meet people’s needs. Staff had been recruited safely.

People were supported to access external healthcare professionals to maintain their health and wellbeing. People were supported to have enough to eat and drink and appropriate referrals had been made to healthcare professionals where people had specific dietary needs.

Staff knew the importance of giving people choices. 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 were supported to plan for and receive appropriate end of life care. There were systems in place for people and relatives to give their feedback on the service.

The provider had systems in place to identify and support people's protected characteristics from potential discrimination. Protected characteristics are the nine groups protected under the Equality Act 2010. They include, age, disability, race, religion and belief. Staff members we spoke with knew people they could tell us about people's individual needs and how they were supported.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update.

The last rating for this service was good. (published September 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to regulation 12 safe care and treatment and regulation 17 good governance. 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 for 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 return sooner.