Archived: Curzon House

Updated 26 February 2021

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.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 16 February 2021 and was announced.

Updated 26 February 2021

We carried out an inspection of Curzon House on the 4 and 8 June 2018. The first visit was unannounced with the second day being announced.

Curzon House 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. Curzon House accommodates 35 people in one adapted building. At the time of our visit, 8 people were living at Curzon House either permanently or for respite care.

The service had a manager who was applying to become registered with us. 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. The manager was present during the days of our visit.

We previously carried out an unannounced comprehensive inspection of this service on 12 and 13 February 2018. At that inspection we rated the service as ‘requires improvement’ as we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

On this visit we found that all breaches in regulations had been addressed.

Our last visit found that the service was not always safe and this had resulted in a breach of Regulation 12 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This was because risk assessments relating to falls were not always in place, medication recording systems were not accurate and training in supporting those who used pressure mattresses was not provided.

This visit found that falls risk assessments were in place and were reviewed regularly. Falls that people had experienced had been kept at a minimum, were analysed to determine patterns or trends were unavoidable and did not adversely put people at risk of harm.

This visit found that medication recording had been improved. Where medication errors had occurred, these had been backed up by auditing systems which were effective and appropriate performance management for staff involved in place.

This visit also found that training in assisting people who required pressure mattresses had been provided with staff having the knowledge and skills to best support people in using this equipment.

Our last visit found that the registered provider had not always worked within the principles of the Mental Capacity Act 2005. This had resulted in a breach of Regulation 11 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We had found that restrictive practices were carried out by staff with no reference to people’s best interests or capacity being recorded. This visit found that a process for making best interests about aspects of people’s lives was in place and was working effectively.

On our last visit we found that governance of the service was inadequate. This had resulted in a breach of Regulation 17 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because auditing of care plans and medication systems had not picked up the shortcoming in medication recording or the lack of a person-centred approach to care plans. We had also found that oversight from the registered provider had not been effective.

This visit found that audits were in place with an ongoing commentary on how any issues were to be addressed. We found that a representative of the registered provider had conducted a detailed visit covering all aspects of the support provided to people who used the service. In turn actions identified were addressed or ongoing.

The premises were clean, hygienic and well maintained. All equipment used had been serviced regularly to ensure that people could use it safely.

Staff were aware of the types of abuse that could occur and how to report it. They were aware of how to raise concerns with outside agencies.

Medication storage was well managed. Staff who had come to work at the service had their suitability to support vulnerable people checked before they came to work there.

Risk assessments were up to date. These related to the risks faced by people in their daily lives as well as from the general environment.

The nutritional people needs of people were met. People were provided with a choice of food at mealtimes and were provided with drinks during the day. Any risks to peoples nutrition were acknowledged and acted upon.

Staff were provided with the training they required to perform their role. They received supervision so that they could be aware of their strengths or areas for development.

The health needs of people were responded to ensure that they maintained their health.

The premises were designed to meet people’s needs and provided signage and decoration to assist those living with dementia.

Staff adopted a kind and friendly approach with people. People were treated with dignity and respect. Staff promoted people’s privacy and dignity at all times.

Care plans were detailed and person centred and subject to effective audits. Information in care plans meant that staff could meet people’s needs in response to changes in people’s physical or mental health.

An effective complaints procedure was in place.

People were invited to participate in activities which were person centred and varied.

The registered provider displayed the service’s ratings from the our last inspection.

The registered provider always let us know about adverse incidents that affected people who used the service.