CQC report explained · a residential care home
What the CQC found at Port Regis
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2019
Rated Good; inspectors found safe, kind and personalised care, with minor improvements still needed to medicine storage and decoration.
This was an unannounced inspection over two days. Inspectors reviewed care records, risk assessments, medicines records, audits, complaints, accidents, incidents and recruitment records. They spoke with people, a relative, staff, managers and health professionals, and observed care.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, good support with medicines, regular care plan reviews and respectful care. People were supported to make choices, keep relationships and access health professionals.
The home had improved since the previous inspection, when it was rated Requires Improvement. Previous breaches relating to risk management, medicines, records, recruitment, quality monitoring and displaying the CQC rating had been met. Inspectors still found that some creams were not stored safely and that decoration on one floor was tired.
Risk management
People's health, welfare and safety risks were assessed. Staff had detailed instructions, including for equipment, catheters, diabetes and behaviours that could be difficult to manage.
“Potential risks to people's health, welfare and safety had been assessed and there was detailed guidance in place for staff to follow to mitigate the risk.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Call bells were answered quickly and staffing levels were consistent.
“There were enough staff to meet people's needs. We observed staff spending time with people, chatting to them, in the communal lounges.” from the report
Respectful care
Staff treated people with dignity, respected their privacy and supported them to remain as independent as possible.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans recorded detailed preferences, such as how people liked their dentures cleaned and what clothes they preferred to wear.
“Care plans included people's specific wishes such as how they liked their dentures to be cleaned and the clothing they liked to wear.” from the report
Cream storage
needs fixingSome creams were kept in people's rooms without a system to ensure safe storage. The provider said cabinets would be supplied, but this had not yet been checked.
“However, some creams were kept in people's rooms. There was no system to ensure that the creams were stored safely.” from the report
Tired decoration
minorThe decoration on the first floor of the main house needed refreshing. The provider said this was due to be done that year.
“The decoration on the first floor in the main house was tired and needed to be refreshed.” from the report
- 01Have the cabinets for storing creams in people's rooms now been supplied, and how do you check that creams are stored safely?
- 02Has the tired decoration on the first floor in the main house been refreshed?
- 03How do you make sure care plans continue to reflect each person's current choices, preferences and support needs?
- 04How do you review falls, accidents and incidents to make sure lessons are acted on?
- 05How are relatives involved when a person's needs change or decisions are made in their best interests?
This was a planned, unannounced inspection of the whole service and all five key questions; the home had been rated Requires Improvement at the inspection published on 16 May 2018. This explanation was written from the published report of 21 May 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
Port Regis rated Requires Improvement; inspectors found kind care and enough staff, but unsafe medicines management and incomplete risk and care records.
This was an unannounced comprehensive inspection on 19 March 2018. It was prompted by concerns from relatives, the local authority and health professionals about staff skills, people's safety and leadership. Inspectors spoke with people, relatives, staff and managers, observed care, and reviewed care plans, medicines, staff records and audits.
The home was caring in its approach. Staff knew people well, treated them with dignity and supported their choices, activities, independence and relationships. There were enough staff to meet people's needs, and people were supported with food, drink and healthcare.
However, inspectors found important safety and management problems. Risks were not always assessed with clear instructions for staff. Medicines records were not reliable. Recruitment checks were incomplete, care plans did not always match people's current needs, and audits had not found these problems. Staff training also needed improvement, including training about dementia, diabetes, catheter care and emergency evacuation.
The overall rating fell from Good at the February 2017 inspection to Requires Improvement. The home was rated Good for Caring, and Requires Improvement for Safe, Effective, Responsive and Well-led. The report identified breaches of regulations and required the provider to send CQC an action plan.
Kind and respectful care
Inspectors saw staff treating people with dignity, patience and compassion. Staff knew people's preferences and supported them in a reassuring way.
“People were treated with kindness, respect and compassion.” from the report
Staffing levels
Inspectors found enough staff to meet people's needs. People said staff responded quickly when they needed help.
“There were enough staff to meet people's needs.” from the report
Activities and interests
People were supported to continue hobbies and take part in activities they enjoyed, including knitting, sewing, art, singing and reminiscence.
“People were able to take part in activities they enjoyed.” from the report
Food and healthcare
People had choices at mealtimes, enough food and drink, and snacks throughout the day. Staff supported access to healthcare professionals when needed.
“People were supported to access healthcare professionals.” from the report
Risk information was not detailed enough
seriousRisk assessments and care plans did not always give staff clear, step-by-step instructions. This included support with catheters, moving people and behaviours that may challenge.
“Potential risks to people had been identified but had not been consistently assessed and there was not detailed guidance for staff to mitigate risks.” from the report
Medicines records were unsafe
seriousRecords did not always show how much medicine was available, whether medicines had been given, why they had not been given, or when bottles had been opened. Inspectors said this created a risk that people would not receive medicines as prescribed.
“Medicines were not always managed safely.” from the report
Recruitment checks were incomplete
seriousThe home had not obtained full employment histories for all staff. Where issues arose from criminal record checks, the reasons for continuing to employ someone and the safeguards used were not recorded.
“The provider had not ensured that recruitment procedures were operated effectively to ensure people employed were of good character.” from the report
Training and evacuation practice
needs fixingTraining relied heavily on DVDs and written questions, with limited face-to-face practice. Not all staff had practised a fire evacuation or using the available evacuation equipment.
“There was limited face to face training which allows staff to debate and ask questions and practice for example, practice using a hoist or practice using emergency evacuation equipment.” from the report
Quality checks missed problems
needs fixingThe home's audits did not cover all important areas and failed to identify the shortfalls found during the inspection. Incident records were also spread across different documents, making learning from incidents difficult.
“The audits had not identified the shortfalls found at this inspection.” from the report
- 01What changes have you made to medicines recording, including recording stock, missed doses and the date bottles are opened?
- 02How do you now make sure risk assessments give staff clear instructions for moving people, catheter care and behaviours that may challenge?
- 03How are care plans checked so they match each person's current needs and do not contain contradictory information?
- 04What training and practical evacuation practice have staff completed since the inspection?
- 05How do your current audits identify problems with care plans, medicines, recruitment and incident records?
This was an unannounced comprehensive inspection of the care home, covering all five CQC questions, after concerns were raised about safety, staff skills and leadership. This explanation was written from the published report of 16 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Port Regis
5 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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