Background to this inspection
Updated
9 April 2021
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 Care Act 2014.
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
Messenger 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
This inspection was announced. We gave a short period notice of the inspection as we were mindful of the impact and added pressures of Covid-19 pandemic on the service. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
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 all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service. We spoke with four members of staff including the registered manager, clinical nurse advisor and care staff.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We spoke with the relative of one person and we continued to seek clarification from the provider to validate evidence found.
Updated
9 April 2021
About the service
Messenger House is a residential care home providing personal care to three people with a learning disability at the time of the inspection. The service can support up to four people.
The service has been designed taking into account best practice guidance and the principles and values underpinning Registering the Right Support (RRS) in respect of the environment. The building design fitted into the residential area as it was domestic in style in keeping with other homes in the street. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.
People’s experience of using this service and what we found
Care plans and risk assessments did not always contain enough detail to inform staff about people's needs. Some of the infection control procedures in place were not in line with current Covid-19 guidance, action has been taken by the provider to address these issues since we inspected.
Quality assurance systems had not always been effective in identifying the concerns we found at this inspection. The registered manager demonstrated a willingness to make improvements and during the inspection began reviewing their systems and processes to ensure the service consistently provided good, safe, quality care and support.
People were positive about their experiences of using the service. They told us they felt safe with staff and that if they had concerns, they could raise them with the manager.
People received their medicines when needed and staff where trained to administer people’s medicines safely. Staff had been recruited safely and there were sufficient numbers of staff on duty to meet people’s needs.
Staff were positive about the management of the service and told us the registered manager was very
supportive and approachable.
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 requires improvement (published 20 December 2019).
The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We undertook this focused inspection to check if they had made improvements since we last inspected. This report only covers our findings in relation to the Key Questions Safe and Well Led which contain those requirements.
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.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Messenger House on our website at www.cqc.org.uk.
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 have identified a breach in relation to good governance. Please see the action we 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 inspect sooner.