Inwood House

Updated 29 October 2022

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

This inspection was carried out by one inspector.

Service and service type

Inwood 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. Inwood 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 not a registered manager in post. A manager was employed to oversee the service and we will refer to them as the manager in the report.

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 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 spoke with two people who lived at the service about their experiences of care received. We spoke with three members of staff and the manager. 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 four people’s care records, multiple medicines records, incident and accident forms, quality monitoring data, health and safety records and two staff files in relation to staff recruitment.

Following our site visit we carried out telephone calls to three relatives, a further three members of staff and we spoke with the manager and one director of the service. We contacted four healthcare professionals for their views about the care provided and received feedback from two of them.

Updated 29 October 2022

About the service

Inwood House is a care home providing accommodation and personal care for up to 20 people in one adapted building. Accommodation is provided over three floors accessed by stairs and a lift. People have their own rooms and access to communal areas such as dining rooms, lounges and a conservatory. The home had an enclosed garden accessed from the ground floor. At the time of the inspection there were 19 people living at the home.

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

Medicines were managed safely and regularly reviewed by healthcare professionals. Staff received training in medicines administration and had their competence checked. There were enough staff available to provide people with care and support in a timely way. Staff had been recruited safely.

Risks to people’s safety had been assessed and action had been taken to mitigate risks and keep them reviewed. 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.

The home was clean and smelt fresh. Systems were in place to make sure all areas of the home had a regular thorough clean. Staff had access to personal protective equipment (PPE) and were observed to wear it appropriately as needed. Staff had been given training and had guidance on infection prevention and control (IPC) good practice. Management carried out IPC audits regularly to monitor systems and practice.

People were being cared for by enough staff. The provider had recruited staff safely and been successful in filling gaps in staffing numbers. Staff were aware of their role in safeguarding which helped to keep people safe. Incidents and accidents had been recorded and reviewed. Any learning was shared with staff to prevent reoccurrence.

People and relatives told us people were safe at the service and they had no concerns with care provided. Relatives told us staff worked hard to meet people’s needs and kept them up to date with any changes. People were able to have visitors when they wished in any part of the service.

Meetings were held regularly, and staff had daily handovers. There were good communications amongst the team, and we were told staff morale was good. Staff felt well supported by the provider and felt able to raise any concern or share their ideas. People had regular reviews which their relatives were involved in.

There was no registered manager at the service, but a new manager had been employed. Feedback about the new manager’s approach was positive. Relatives, staff and professionals told us the manager was approachable, calm and attentive. Support was available to the manager from the provider and the owners visited regularly.

Quality monitoring systems were in place which helped to check various areas of the home. Any actions identified were carried out to make sure the service was continually improving. Following the inspection in October 2021 we imposed a condition on the provider’s registration to submit a monthly action plan to CQC. The provider had complied with this condition and we received a regular action plan. Whilst we saw improvements had been made, not all incidents had been notified to CQC. We have made one recommendation about governance systems.

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 11 February 2022) and there were breaches of regulations. At this inspection we found the provider had carried out the required improvement but further improvement was needed.

At our last inspection we recommended that the provider reviewed systems to make sure topical creams were consistently dated when opened. At this inspection we found the provider had acted on the recommendations and made the improvements to topical creams.

Why we inspected

We carried out an unannounced focused inspection of this service on 28 October 2021. Three breaches of legal requirements were found. We served the provider a Warning Notice for a breach of regulation 12, we also imposed a condition on the provider’s registration for a breach of regulation 17 and we issued a requirement notice for a breach of regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

We returned on 6 January 2022 to check the provider had complied with a Warning Notice we served for a breach of regulation 12. We found they had made the improvement required and were no longer in breach of regulation 12.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. At this inspection we found the provider had carried out the improvement required to no longer be in breach of regulations.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has improved to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inwood House on our website at www.cqc.org.uk.

Recommendations

We have made one recommendation for governance systems.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.