Vishram Ghar

Updated 9 December 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We received information of concern about infection control and prevention measures at this service. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 18 November 2020 and was unannounced.

Updated 9 December 2020

This comprehensive inspection took place on 30 October 2018 and was unannounced.

At our last comprehensive inspection on 25 January 2018, we rated the service as requires improvement. This was because risk assessment lacked detail and sufficient guidance for staff to keep people safe, medicine records were not always completed accurately, staff did not always follow safe infection control, people did not receive consistent support with their meals, there were limited opportunities for hobbies and activities and systems for monitoring the quality of the service was not effective in bringing about improvements. At this inspection we found the provider had made significant improvements to address these shortfalls, although further improvements were needed to ensure people were consistently safe.

Vishram Ghar 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.

Vishram Ghar accommodates up to 44 older people across two separate units, each of which have separate adapted facilities. One of the units specialises in providing short term care to people who are under assessment following illness, injury or hospital discharge. The second unit support people who require long-term care, some of who were living with dementia. At the time of our inspection there were 39 people using the service.

A registered manager was in post at the time of the inspection. 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.

There were enough staff to meet people's needs. However, staff were not always deployed effectively to provide people with consistent support and engagement.

There were improvements to protect people from the risk of infections. However, these were not fully embedded into all staff working practices.

Staff understood how to protect people from the risk of abuse and procedures that should be followed to report suspected abuse. People had risk assessments in place to cover any risks that were present within their lives, whilst also enabling them to be as independent as possible.

There were safe systems in place for the administration of medicines and people received their medicines as prescribed.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.

People received effective care and support from staff that had the skills and knowledge to meet their needs. Staff attended training where they completed mandatory training and received on-going training to enable them to fulfil the requirements of the role. Staff felt well supported by the registered manager and deputy managers.

People were able to choose the food and drink they wanted and staff supported people with this. Further development of the meal service was planned to ensure the serving of meals was efficient. Staff supported people with health appointments where necessary. Health professionals were involved with people's care as and when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice. People were encouraged to make decisions about their care, daily routines and preferences. Staff worked within the principles of the Mental Capacity Act 2005.

People were cared for by a staff team who were friendly, caring and compassionate. Positive relationships had been developed between people and staff. People were treated with dignity, respect and kindness.

People were involved in their own care planning as much as they could be, and were able to contribute to the way in which their care was provided. Care planning was personalised and reflected people's wishes and preferences, so that staff could understand their needs fully. People were in control of their care and listened to by staff. Care records were regularly reviewed to ensure they reflected people's current needs.

People had access to activities and were supported to go out into their local community. The registered manager was developing contingency plans to ensure activities were always available in the absence of the activity co-ordinator.

The provider encouraged people and relatives to share their views about the service. Complaints were responded to in a timely manner and used to drive improvements in the service.

Quality monitoring systems and processes were in place and comprehensive audits were taking place within the service to identify where improvements could be made.

The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and transparent, and any improvements were highlighted and worked upon as required.