York House

Updated 17 January 2024

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 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

York House 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. York House is a care home without 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 our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 16 November 2023 and ended on 29 November 2023. We visited the location’s office/service on 16 November 2023.

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. Due to technical problems, the Provider Information Return (PIR) was not available at the time of the inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who used the service and 2 relatives about their experience of the care provided. We received feedback from 6 members of staff including the registered manager, deputy manager and care staff. We reviewed 3 people's care files and 2 staff personnel files. We also reviewed records relating to managing the service.

Updated 17 January 2024

About the service

York House is a residential care home providing accommodation for persons who require personal care to up to 13 people. The service provides support to people with mental health needs. At the time of our inspection there were 13 people using the service, 3 of whom needed support with personal care.

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

Risks to people had not always been assessed and staff did not always report incidents. The registered manager had not ensured enough staff were trained in medicines administration and competency checks were not completed.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We found there was room for improvement to involve people in decisions about their care and with promoting their independence.

People and their relatives were happy with the care provided. However, people had very limited support with activities, and no one had any goals. Staff were not trained in end-of-life care and there was no information about people’s wishes at the end of their life in their records. At the time of our inspection no one required end of life care.

The systems to monitor the quality of the service were not robust. The registered manager lacked oversight of incidents. They were responsive to our concerns and worked well with other professionals. People, their families and staff spoke positively about the staff and manager.

Staff received training and supervision. People were involved in menu planning and given choices of what they ate and drank.

People’s care plans included details of their communication needs. There was a complaints procedure which people were aware of.

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 (27 July 2016).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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

Enforcement and Recommendations

We have identified breaches in relation to risk assessments, incident management, staff training and competency checks, personalised activities and governance processes. We found no evidence during this inspection that people have experienced harm from these concerns.

We have made a recommendation related to mental capacity assessments.

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 the standards of quality and safety. 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.