Quebec Hall Limited

People who used the service were supported by enough staff who had the skills and training to support them safely. Staff were safely recruited and underwent an induction process. Staff were well supported by the management team. Some staff received additional training to enable them to administer medicines and had their competency to do this checked. Medicines were safely managed and, where people administered their own medicines, there were risk assessments in place for this.

Staff understood their responsibility to report and act on safeguarding concerns, should they suspect a person was at risk of abuse or experiencing abuse. The registered manager reported safeguarding concerns to the local authority safeguarding team and to CQC. However, we identified three instances where this had not taken place. People were not injured and had not come to harm, but best practice would have been to report any concerns. The registered manager acknowledged this and noted for future occasions.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. However, we identified one concern where there was no record of a capacity assessment for people sharing rooms. The provider acknowledged this and committed to addressing this as soon as possible. People were not subject to unlawful or excessive restrictions, and they had choice, control and freedom over their lives.

Risks were identified, mitigated and well monitored to ensure changes to risk assessments were not required. Infection control risks were well managed, with care staff having additional cleaning duties to supplement and heighten cleaning procedures. The service was clean and odour free. The environment was safe and many people were able to access all areas of the service independently. Equipment, such as hoists and stand-aids, was well maintained. Maintenance staff carried out regular safety checks to ensure systems were working correctly and the building remained in a good state of repair.

People’s needs were assessed prior to them coming to live at Quebec Hall and regularly reviewed. People’s needs relating to eating and drinking were well managed and staff were seen promoting additional drinks during a period of very hot weather. The service was kept reasonably cool and people were comfortable. People were provided with a nutritional diet with plenty of choice. Health needs were well monitored and appropriate referrals made when needed, to the falls team or speech and language therapists for example. People consented to their care and were given opportunities to feed back on all aspects of the service in surveys and meetings. The provider took note of people’s feedback and action followed.

Care was person centred. Staff were kind and relationships between staff and the people they were supporting and caring for, were good. Care was unhurried and the atmosphere was calm. Staff were very positive about the service, with one saying. ‘They are a family – it is about the relationships with people.’

There was good oversight by the registered manager and the general manager, with systems and processes in place to monitor all aspects of the service. The service planned to further improve this by introducing electronic systems soon. Staff were well supported with supervision sessions and staff meetings. There was a shared direction and culture based on Christian faith but not excluding those of other or no faith. People were supported and cared for whilst their independence was maintained as much as possible.