The Polegate Care Home

Updated 6 January 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 one inspector.

Service and service type

The Polegate Care Home 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. The Polegate Care Home 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 the inspection there was no registered manager at the service. However, a manager had been recruited and was due to start in January 2023. In the interim a ‘turnaround manager’ employed by the provider was overseeing the day to day running of the home. They will be referred to as the manager throughout the report.

Notice of inspection

This inspection was unannounced.

What we did before the 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 reviewed all the information we hold about the service including statutory notifications sent to us by the provider about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We also contacted the local authority market support team for feedback. We used all of this information to plan our inspection.

During the inspection

Not everyone living at The Polegate Care Home was able to tell us about their experiences of living in the service. We spent time observing the interactions between people and staff in communal areas of the home, in order to help us understand people's experiences and spoke to visitors. We chatted with 5 people living at The Polegate Care Home. During and following the inspection we sought feedback from visitors to the home. This included relatives, friends and health professionals. We spent time observing care and reviewing care records to help us understand the experience of people who could not talk with us. We spoke with 11 members of staff including the manager, deputy manager, area and senior area director, care and nursing staff.

We looked at documentation in relation to the running of the service and care provision. This included 3 people’s care plans in full and another 4 to look at specific health needs. We also looked at 6 room folders used to document care provided to people throughout the day. We reviewed accident, incident and safeguarding processes, electronic medication records, 2 staff recruitment files and a variety of records relating to the governance and management of the service. This included provider improvement/action plans.

Updated 6 January 2023

About the service

The Polegate Care Home is a residential care home providing nursing and personal care for up to 44 people. At the time of the inspection there were 25 people living in the service. People were living with a range of nursing and support needs.

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

There were a number of staff vacancies throughout the home. This meant agency staff were being used to ensure staffing levels were maintained. New staff working at the home had not been able to read people’s care plans. There was an over reliance on verbal information sharing and new staff were not always being supported by an experienced member of staff.

Care plans and risk assessments were in place. Care plans were reviewed monthly or more frequently if changes occurred. However, daily records had not been maintained appropriately. Elements of people’s personal care, including mouthcare, repositioning and regular checks were not consistently documented. Staff were not aware which daily charts should be completed for people.

There had not been a registered manager at the service since July 2022. A ‘turnaround’ manager had been put into post by the provider to manage the home until a new manager was recruited. A new manager was due to start in January 2023.

Visitors to the home gave mixed feedback and everyone was aware that there had been a number of staff changes. People told us they wanted more consistency. The provider and manager were working hard to recruit new staff including recruitment from abroad.

Safe recruitment procedures were in place. All appropriate checks were completed before new staff began working at the home. Staff received a three-day induction which included a period of shadowing experienced staff.

There were safe medicine practices and people told us they received their medicines at the right time. Staff administering medicines received training and had their competencies assessed. Staff demonstrated a good understanding of protecting people from abuse. Safeguarding procedures were discussed with staff during group supervisions and any learning taken forward.

Infection control procedures were being followed and the home was clean and tidy. Staff and management were aware of any actions to follow in the event of any outbreaks of COVID19.

People were able to provide feedback about the way they received their care. Resident and relatives’ meetings had been scheduled and staff received group supervisions. Staff told us meetings were a helpful way of communicating any changes. All feedback was being used to implement positive changes to improve the home.

Quality assurance checks and had been completed. This included a programme of auditing which incorporated all aspects of care delivery and services.

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 25 January 2020).

Why we inspected

The inspection was prompted in part due to concerns received in relation to staffing, person centred care and documentation. 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 COVID-19 and other infection outbreaks effectively.

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 good to requires improvement based on the findings of this inspection.

Enforcement and Recommendations

We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to 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 from the provider to understand what they will do to improve. 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.