Background to this inspection
Updated
2 October 2020
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 and an assistant inspector.
Service and service type
Pytchley Court Nursing Home 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 unannounced, however, we phoned the service before entering. This supported the service and us to manage any potential risks associated with Covid-19.
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. 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 used all of this information to plan our inspection.
During the inspection
We spoke with one person people who used the service about their experience of the care provided. We spoke with six members of staff including the registered manager, maintenance person and care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four 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 communicated with three relatives about their experience of the care provided.
We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies and procedures and quality assurance records.
Updated
2 October 2020
About the service
Pytchley Court Nursing Home provides nursing and residential care for up to 40 older people, including people living with dementia. There were 29 people receiving care at the time of the inspection.
People’s experience of using this service and what we found
Infection control procedures required improvement. Personal protective equipment [PPE] had not been disposed of appropriately and cleaning schedules were not detailed with actions taken.
There were insufficient systems in place to identify any shortfalls in the care received. Audits that had been completed, had not always identified the concerns or had actions documented. Records of care were not consistently completed and had not audited.
Not all staff and relatives felt there were enough staff on duty to meet the needs of everyone living at Pytchley Court Nursing Home. Although people were supported by staff who knew them well and had been safely recruited.
Risk assessments were in place to protect people from harm, however these were not consistently followed by staff. Although, we saw no evidence of harm occurring.
People were supported with their medicines safely.
Staff told us they felt well supported by the management and enjoyed their job.
People were supported to feedback on the service they received and significant people were kept up to date regarding peoples changing needs.
Relatives we spoke to were all positive about the care and support given by staff.
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 27 April 2019).
The service remains rated requires improvement.
Why we inspected
We received concerns in relation to staff training, record keeping and clinical oversight. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-Led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We have found evidence that the provider needs to make improvements.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pytchley Court Nursing home 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 monitor the service.
We have identified breaches in relation to oversight of the service at this inspection.
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 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.