Background to this inspection
Updated
8 March 2023
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 2 inspectors and an Expert by Experience (ExE). 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
Inver 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. Inver 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 8 February 2023 and ended on 22 February 2023. We visited the service on 8 and 14 February 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We sought feedback from the local authority professionals who had recently had engagement with the service following concerns raised.
The provider completed 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 13 people who used the service and 8 relatives about their experience of the care provided. In addition, we received feedback through our website from 2 more relatives. 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 spoke with 10 members of staff including the provider’s area manager, the registered manager, the deputy manager, care staff, activity staff and domestic staff.
We reviewed a range of records. This included 7 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and a variety of records relating to the management of the service, including staff rotas, training records, policies and procedures. We looked at health and safety records and quality assurance records. We received feedback from 5 external professionals who have had recent involvement with the service.
Updated
8 March 2023
About the service
Inver House is a residential care home providing personal care to up to 50 people across three separate wings, each of which has separate adapted facilities. The service provides support to older people and in two of the adapted wings, supports those living with more significant dementia. At the time of our inspection there were 37 people using the service.
People’s experience of using this service and what we found
Risks to people were assessed and there was information within people's care plans so that staff could safely meet people's needs. Some improvements were needed to ensure information about risks and how these should be mitigated was clear and consistent.
There were enough staff to meet people’s needs safely. However, over the three units, staff were not always able to spend quality time engaging with people. We discussed this with the provider who were reviewing this and supporting staff development.
The provider used an external company to carry out recruitment checks on new staff. While this was safe, some improvements were needed to ensure the management team were aware of any actions they needed to follow up on. There was ongoing recruitment to continue to build the staff team.
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. Mental capacity assessments had been completed for people and were appropriate for the decisions being made. However, we identified some additional records were needed for some people. Staff understood how to support people to make choices about their life and people told us they were asked their views.
People told us they felt safe at Inver House. Information was shared with staff at handovers between shifts and other meetings, meaning staff understood how to keep people safe. The environment and equipment was clean, safe and well maintained and fire risks were managed well.
People were protected from abuse and staff understood their responsibilities to report any concerns. Staff respected people's human rights and diversity, and this helped prevent discrimination.
Medicines were administered by suitably trained staff who had been assessed as competent to do so safely. Appropriate arrangements were in place for obtaining, recording, administering and disposing of prescribed medicines.
Accidents and incidents were monitored so that action could be taken to reduce the likelihood of a reoccurrence.
Activities were available and varied and staff supported people to maintain relationships with their relatives. There were positive links with the local community.
There was no one receiving end of life care at the tie of our inspection. However, people’s wishes at the end of their life had been captured in advanced care plans.
Staff felt they were supported in their role and told us they enjoyed working in the service.
The provider had systems and processes to effectively monitor the quality of the service provided within the home and there was a complaints process. The registered managers understood their regulatory responsibilities and shared information when required.
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 (published 4 October 2018).
Why we inspected
We received concerns in relation to staffing, management oversight, safeguarding, risk management and medicines safety. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We found evidence during this inspection that some improvements were needed to risk management, recruitment, mental capacity assessments and staff engagement. Please see the safe, responsive and well led sections of this full report.
The overall rating for the service has remained good based on the findings of this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inver House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.