Sovereign House

Updated 10 January 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.

Inspection team

On the first inspection visit, this was carried out by 2 inspectors, a specialist advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

On the second inspection visit, this was carried out by 1 inspector.

Service and service type

Sovereign House 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.

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.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the location on 16 November and 02 December 2022. We spoke with 16 people who used the service and 5 relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, deputy manager, area manager, nurses, care workers and domestic staff.

We reviewed a range of documents. This included 7 people's care records and multiple medicine administration records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 10 January 2023

About the service

Sovereign House is a nursing home providing personal and nursing care to up to 60 people across 3 different floors. The service provides support to adults, including people living with dementia. At the time of our inspection there were 34 people who lived at the home permanently and 18 people were staying at the home for a short period of assessment or rehabilitation following time spent in hospital.

People’s experience of using this service and what we found

Assessment of risk to people’s health and safety were not always robustly completed or mitigated. We found concerns regarding the lack of risk assessments and care plans for some people.

The management and administration of medicines was not always completed safely and maintenance of the home environment did not always promote effective infection control.

Staff supporting people living with dementia or communication difficulties required further training; however, there were enough suitable staff working at the home to support people's needs. People were safeguarded from the risk of abuse and the provider had systems and processes in place to respond to concerns.

The management team did not always have effective oversight of risk within the service. Clinical governance was not always completed to ensure staff had the training and competence to provide care and treatment safely.

People and staff were asked to provide feedback to obtain their views and experiences which was analysed and action plans put in place.

The registered manager and provider understood their legal duties and requirements and responded to risks identified within the service. The provider supported the management team to drive improvement in the home. The service worked with other health and social care professionals effectively.

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.

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 requires improvement (published 06 January 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 the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about the management of continence products used at the service and the findings from the last inspection. As a result, we undertook a focused inspection to review the key questions of safe 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 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.

We have found evidence the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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 Sovereign House 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account when it is necessary for us to do so.

We have identified continued breaches in relation to the assessment of risk, medicines management, infection prevention and control and the lack of management oversight 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.