Archived: Churchill House

Updated 18 January 2016

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 registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 November and 1 December 2015 and was unannounced. The inspection team consisted of one adult social care inspector and an expert-by-experience [ExE]. An ExE is a person who has personal experience of using or caring for someone who uses this type of care service for example, people living with dementia.

The registered provider had not yet been asked to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. However, we looked at notifications sent in to us by the registered provider, which gave us information about how incidents and accidents were managed.

We spoke with the local safeguarding team and the local authority contracts and commissioning team regarding their views of the service. There were no outstanding concerns from these agencies.

During the inspection we observed how staff interacted with people who used the service throughout the days and at mealtimes. We spoke with six people who used the service and four relatives. We spoke with the registered provider, the registered manager, four care workers and a cook.

We looked at four care files which belonged to people who used the service. We also looked at other important documentation relating to them such as accidents and incidents and the medication administration records [MARs] for all 23 people. We looked at how the service used the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf.

We looked at a selection of documentation relating to the management and running of the service. These included four staff recruitment files, the training record, the staff rota, supervision logs, minutes of meetings with staff, quality assurance audits, complaints management and maintenance of equipment records. We looked around the service to make sure it was clean and tidy.

Updated 18 January 2016

Churchill House is situated to the east of the city of Hull, on a main road with public transport facilities and local shops within walking distance. The service is registered to provide accommodation and personal care for a maximum of 24 people some of whom may be living with dementia. All bar one of the bedrooms are for single occupancy. There are two communal sitting rooms with a dining area, and bathrooms and toilets on both floors. There is an accessible garden and car parking at the front and rear of the building.

We undertook this unannounced inspection on the 30 November and 1 December 2015. There were 23 people using the service at the time of the inspection. At the last inspection on 5 April 2013, the registered provider was compliant in the areas we assessed.

The service has a registered manager. 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 registered provider told us the service was to be sold as a going concern. They confirmed people who used the service, their relatives and the local authority contracts and commissioning team had been informed of this decision. The registered provider and registered manager told us they wanted this to proceed with the least disruption for the people who used the service; they demonstrated a kind and compassionate approach when they told us of their decision.

We found people did not always receive their medicines as prescribed. This issue meant the registered provider was not meeting the requirements of the law regarding the management of medicines. You can see what action we told the registered provider to take at the back of the full version of the report.

We saw arrangements were in place to make sure people had access to health care professionals when required.

People told us they liked the meals provided to them and menus were varied. It was difficult to consistently check if people were always receiving sufficient amounts to eat and drink as some staff were more vigilant than others in recording this. We mentioned this to the registered manager to address with staff.

We found staff knew people’s needs well and provided them with person-centred care, despite some issues of missing information in care plans. People told us staff looked after them well, were kind and caring and respected their privacy and dignity.

We found there were limited activities provided to people. We made a recommendation regarding the registered provider implementing the findings of a recent dementia mapping exercise and seeking advice about appropriate activities for people.

Staff involved people and sought consent from them prior to carrying out tasks. We saw when people were assessed as lacking capacity to make their own decisions, the registered manager worked within the law; however we found decisions about mental capacity issues could be better recorded.

We saw recruitment checks were carried out, although in two instances the members of staff had started work before their references had been returned. People told us there were sufficient staff to support them and they were not kept waiting long when they called for assistance. However, the registered provider had noted a gap on some days and recruitment was well underway for an additional member of staff each morning and across tea-time every day.

Staff had received training in how to safeguard people from abuse or harm; they knew how to report concerns. Risk assessments were in place, although these could contain clearer guidance for staff in how to minimise risk whilst ensuring people remained as independent as possible. Equipment used in the service was maintained.

We found staff had access to training and support. Although formal supervision was behind schedule, staff told us they could talk to the registered manager at any time and they were available for advice.

We saw there was a complaints procedure on display and people told us they felt able to raise concerns in the belief they would be addressed.

We found there was a quality monitoring system in place that consisted of questionnaires, meetings to gain views and audits. This system was undergoing review to ensure it was more comprehensive. We made a recommendation that the registered provider continues with improvements for the quality monitoring system.