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Regulator finds Savernake View Care Home still 'requires improvement'

After an unannounced inspection by a team of four in April, the Care Quality Commission (CQC) has issued a report on the Savernake View Care Home at Priory Court on the Salisbury Road - which makes for some surprising reading.  The care home is run by Porthaven Care Homes No 2 Ltd.
The CQC finds that the care home, which was officially opened by Angela Rippon in June last year, 'requires improvement' in four out of the five 'key questions' by which it judges care homes.

The CQC inspectors planned to return to Savernake View to make sure four breaches of regulations discovered at their 2017 inspection had been put right: "This inspection was brought forward due to complaints received about the quality of care people received since our last inspection."  The report does not give any further information on these complaints.

Following the inspection in April 2018, the CQC inspectors has given a 'Good' rating for is 'Is the service caring?'  In the report this is supported by a number of glowing opinions from occupants and families: "People spoke highly about the care they received.  They said staff treated them with kindness and compassion."

Residents and families were also were favourably impressed by the care home's safety.  Despite that, problems arise with the other four 'key questions': 'Is the service safe?', 'Is the service effective?', 'Is the service responsive?' and 'Is the service well-led?' - which all still merited the 'requires improvement' rating.

If this all seems a bit harsh, in two of these - safety and effectiveness - the inspectors said Savernake View was now meeting 'legal requirements'. 

However: "While improvements had been made we have not revised the rating for this key question; to improve the rating to 'Good' would require a longer term track record of consistent good practice." No timescale was given - these ratings will be reviewed 'at the next comprehensive inspection’.   It seems that in these two instances this rating is designed to keep the care home working at imporvements.

Under 'responsiveness' the CQC '...found that sufficient action had not been taken to improve' matters.  The main problems arose from the failure of 'care plans' to be concentrated properly on the individual's care needs and choices.

Inspectors found that action had been taken to improve the leadership of the service, but the 'requires improvement' remained due to incomplete record keeping about people's care.

Savernake View can accommodate 64 residents across three separate units  - one of which takes 38 people living with dementia. The dementia unit gave rise to some more general criticisms about the design and decoration of the unit, and about a lack of 'enough meaningful activity'.  A member of staff commented: "It's more like a hotel really than a dementia friendly place."

The report gives one specific - and bleak - example: "Several people walked along the corridors, until they came to the end and a locked door.  They looked through the window in the door, trying to open the door.  Some people became distressed and staff had to distract them away from the door."

The 2017 report noted 'significant...concerns' about staff shortages.  The inspection this April found that the calibre of staff had been raised, far fewer agency staff were being used and staff training had been improved.  The report stated "Comments from staff included: 'The training is so much better now.  The new system means we can track people's learning, so nobody slips through the net'."

There has been some confusion over the timing of the publication of this report. It had a publication date of June 26, but was actually published on August 1 - naming the two regulated activities that were not being met and the "Action we have told the provider to take" about care plans and record keeping.

The CQC rate care homes - as well as hospitals and other health service providers - as being Outstanding, Good, Requires Improvement or Inadequate.  In the past month they have given 37 'Outstanding' ratings, 774 'Good' ratings, 369 'Requires improvement ratings and 91 'Inadequate' ratings.


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