Victoria House

We assessed 6 quality statements in the safe key questions and found areas of concern. The scores for these areas have been combined with the scores based on the rating from the last inspection, which was good. The rating for this key question has changed to requires improvement. We found that people did not always feel safe. Staff deployment was not managed effectively which impacted the quality and safety of people’s care. People felt rushed, receiving task-based care with people they did not know and who were not always appropriately trained. Appropriate checks during the recruitment process had not always been recorded. We made a recommendation in this area. Risks to people had not always been assessed and systems had failed to identify areas of risk after an accident had occurred. Risk from equipment had not been considered and action taken to address this issue by the provider was slow during the assessment. The service was not always clean, improvement was needed to address the infection, prevention and control practices within the service. We found a breach of regulation in relation to safe care and treatment and staffing. Systems were in place to monitor safeguarding incidents, however, not all incidents had been reported to the appropriate regulatory bodies. Mental capacity assessments and best interest decision meetings had not always taken place. People’s restrictions were not always managed appropriately and details around these restrictions were unclear. We found a breach of regulation in relation to people’s need for consent. We found people gave positive feedback regarding the management of their medicines, however, there was a high level of medication errors within the service. The provider had highlighted this concern and was working to improve this. We made a recommendation regarding the safe management of medication.

We assessed 1 quality statement in the effective key question and found areas that required improvement. However, the score for this area has been combined with scores based on the rating from the last inspection, which was Good. The rating for this area remains Good. We found that people were happy with the quality of the food served, however areas of the dining experience could be improved to ensure people’s choices and dignity are respected.

We assessed 1 quality statement in the caring key question and found areas that required improvement. However, the score for this area has been combined with scores based on the rating from the last inspection, which was Good. The rating for this area remains Good. People reported kind interactions from staff who knew them, however there was mixed feedback regarding the care and compassion from the agency staff.

We assessed 5 quality statements in the responsive key question and found areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was Outstanding. The rating for this key question has changed to Good. We found that care was often rushed, and task based due to the staffing constraints within the service. People had to wait for care as trained staff were not always available to provide the care they needed. Some staff members knew the people well; however, a high number of agency staff impacted the services ability to provide person centred care. People were not always included when changes were made in the service, and we found that not all information available was in accessible formats for people to fully understand. Feedback surveys had been collected by the service however people told us they did not always feel listened to. We found a breach of regulations in relation to person centred care. People were supported to access health and social care services when needed and staff escalated health concerns to ensure the correct level of care was provided. Referrals had been made but improvements were needed in record keeping ensuring outcomes and follow up information could be reviewed.

We assessed 4 quality statements in the well led key question and found areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. The rating for this key question has changed to requires improvement. We found a breach of regulation in relation to the governance of the service. We found that the service was not always well led. Inconsistencies in the management of the service had led to shortfalls in the oversight of the service and systems put in place to monitor the safety and effectiveness of the care had been ineffective. Audits that were in place did not always have an action plan to address identified issues. In some cases where an action plan was in place, action to address these areas of concern was slow. Risks had not always been assessed and records were not always accurate and up to date. Staff did not always feel supported in their roles; however, they were positive that improvements would be seen now a new manager was in post.