19 April 2023
During a routine inspection
East Riding Care Home provides accommodation, personal and nursing care for up to 67 people; some of whom are living with a dementia related condition. At the time of the inspection there were 37 people living at the home. Support is provided across 2 floors in 3 units which have been adapted to meet people's needs.
People’s experience of using this service and what we found
Action had been taken following the last inspection to deliver improvements. However, we identified on-going issues with the management of medicines and the oversight of this. Governance systems had improved but more work was required to ensure medicines audits were effective in identifying issues to enable staff to take the appropriate action to make sure medicines were managed safely.
The registered manager worked in an open and transparent way and understood their responsibilities in relation to the duty of candour regulation. Appropriate documentation was in place in response to any notifiable safety incident.
Policies and procedures in relation to infection prevention and control (IPC) to prevent the spread of infections were in place. Arrangements were in place to support people to maintain contact with people important to them. This included indoor visits from relatives or friends and supporting people to maintain contact using technology.
Systems were in place to review incidents to assess if any improvements to staff practice could be made. Safe recruitment procedures had been followed and there were enough staff deployed to meet people’s needs. Systems were in place to safeguard people from the risk of abuse and the risks people were exposed to had been assessed.
Staff received training which the provider had assessed as mandatory and staff told us they felt supported in their job role. Staff were positive about the registered manager and told us East Riding Care Home was a nice place to work. One member of staff told us, “[Name of registered manager] is interested, she's involved, she helps, and she will stay and cover. It makes people feel better when you know she will do what we are expected to do.”
Staff were kind and spoke fondly about their relationships with people. They described situations where they had gone out of their way to provide person-centred support for people. One staff member said, “I can see the difference from when I first started. It's nice to see the residents with a smile on their face. I feel proud to work here and to make the home a nice, pleasant place for residents to live in.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Best interest’s decisions were completed for people who could not consent to their care and treatment in line with legal requirements.
People’s communication needs were met. Information was available to people in alternative formats to support people’s communication needs. End of life care plans were in place to ensure any wishes people had for their end of life care were recorded. Staff provided care and support which was person-centred to the individual needs of people. Systems were in place to investigate and respond to any complaints and to acknowledge any compliments.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 21 November 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made. However, the provider remained in breach of regulations.
This service has been in Special Measures since 17 November 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We carried out an unannounced comprehensive inspection of this service on 13 September 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person-centred care, dignity and respect, safe care and treatment, safeguarding, nutrition and hydration, good governance, staffing, safe recruitment, duty of candour and notification of incidents.
We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.
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 monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.