The comprehensive inspection of Victoria Care Centre took place on 22 and 31 May 2018. The first day of the inspection was unannounced.

Victoria Care Centre is a ‘care home.’ It provides nursing care and accommodation for a maximum of 115 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Victoria Care Centre accommodates 115 people in one purpose built building. During our visit there were no vacancies. People using the service had a range of needs, most were older people, some of whom were living with dementia. A service was also provided to younger adults and others who had varied needs including physical disabilities and/or mental health needs.

People’s bedrooms were in units located on the four floors of the premises. There is a passenger lift that provides access to each floor. People have access to safe outdoor space and the home is located close to shops and public transport.

At the last comprehensive inspection of 12 and 13 May 2016 we rated the service good overall. The service was rated requires improvement in the area of safe as a breach of legal requirements was found due to the way people’s medicines were managed by the service. At our focused inspection on the 24 November 2016, we found that the provider had taken action to address our concerns and met legal requirements that people’s medicines were managed and administered safely by the service.

The service has a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff engaged with people in a respectful and positive manner. They had a good understanding of each person’s needs and knew how to provide them with the care and support that they required and wanted. People and their families were involved in decisions about people’s care.

People's care plans were up to date and included information staff required for providing people with personalised care and support. People’s healthcare needs were assessed and monitored closely. The service worked with healthcare and social care professionals to ensure people’s needs were met.

Arrangements were in place to keep people safe. Staff knew how to identify abuse and understood the safeguarding procedures they needed to follow to protect people from harm.

Risks to people's health and well-being were identified, assessed and managed as part of their plan of care and support. Staff understood their responsibilities to deliver safe care and to report to the nursing staff or management any concerns to do with people’s safety including any poor practice from staff.

Arrangements were in place to ensure that medicines were managed safely and people received the medicines that they were prescribed.

People using the service were supported to take part in a range of preferred and meaningful activities. The service had plans to develop and improve the range and number of activities available to people.

People’s nutritional needs and preferences were met by the service. People chose what they wanted to eat and a range of snacks and drinks were available at any time.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s privacy was respected. Staff understood the importance of treating people with dignity and respecting their differences and human rights.

Staffing levels and skill mix were flexible to ensure that people were provided with the assistance and care that th

We carried out an unannounced comprehensive inspection of this service on12 and 13 May 2016. At which a breach of legal requirements was found. This was because the provider did not always ensure the proper and safe management of people’s medicines.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook an unannounced focused inspection on the 24 November 2016 to check they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to the safety topic area. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Victoria Care Centre on our website at www.cqc.org.uk.

At our last inspection in May 2016 we rated the service good and in the four topic areas; effective, caring, responsive and well-led and good as the overall rating. The service was rated requires improvement in the topic area safe.

Victoria Care Centre provides accommodation and personal and nursing care for up to 115 people some of whom may have dementia or physical disabilities. The home is purpose built and located in north west London. Public transport is accessible and there are shops within walking distance of the service.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission [CQC] to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our focused inspection on the 24 November 2016, we found that the provider had followed their plan and legal requirements had been met. The provider had taken action to address our concerns about the way medicines were managed by the service. We found people’s medicines were stored and managed safely so people were protected from unsafe treatment.

This unannounced comprehensive inspection of Victoria Care Centre took place on the 12 and 13 May 2016.

At our last inspection of this service on 5 November 2015, two breaches of legal requirements were found. These related to the management of risks to the health and safety of people and a shortfall in the maintenance of accurate complete records to do with the care and treatment provided to people. During this inspection we found the provider had followed their action plan, and now met legal requirements by having arrangements in place to manage risks to the health and safety of people using the service and maintaining accurate records in respect of the care and treatment provided to people.

Victoria Care Centre is a care home that provides personal care and accommodation for 115 people some of whom have dementia or physical disabilities. At the time of our inspection there were 113 people living in the home.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission [CQC] to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act [HSCA] 2008 and associated Regulations about how the service is run.

People were treated with respect, and staff engaged with people in a friendly and courteous manner. People told us staff were approachable, listened to them, respected their privacy and were kind. Throughout our visit we observed caring and supportive relationships between staff and people using the service.

People told us they felt safe. Staff understood how to safeguard the people they supported. People’s individual needs and risks were identified, managed and reviewed as part of their plan of care and support. Care plans had recently been reviewed and were personalised and reflected people’s current needs. They contained the information staff needed to provide people with the care they wanted and needed. However, we found some deficiencies in the management and administration of medicines.

People were provided with choice and their decisions respected. They had the opportunity to participate in a range of activities and were provided with the support they needed to maintain links with their family and friends.

Staff had an understanding of the systems in place to protect people if they were unable to make one or more decisions about their care, treatment and other aspects of their lives. The registered manager knew about the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS were in place when it was necessary to restrict people’s freedom in some way. However, some staff were unclear about their responsibilities regarding the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and their implications for people living in the home.

People were supported to maintain good health. They had access to appropriate healthcare services that monitored their health and provided treatment and advice when people were unwell. People were supported to maintain their mobility. People’s nutritional needs and special dietary requirements were understood and catered for by staff.

Staff were appropriately recruited, trained and supported to provide people with the care they needed. Staff told us they enjoyed working in the home and received the support they needed to carry out their roles and responsibilities.

People knew how to raise concerns and complaints if they needed to. Appropriate action was taken to address issues that were raised. People’s views of the service were sought and responded to appropriately.

There were systems in place to regularly assess, monitor and improve the quality of the services provided for people. Some areas of quality assurance were in the process of being developed and improved.

We found one breach of the new Health and

We undertook an unannounced focused inspection on the 5 November 2015 in response to an incident that took place at the home on the 9 October 2015. After the incident the provider wrote to us to tell us what they would do and had done to make sure people were safe and to minimise and manage the risk of a similar incident happening again. We carried out this focused inspection to assess the safety of people using the services, to check the provider had followed their action plan and to make a judgement as to whether the provider was meeting legal requirements.

This report only covers our findings in relation to the safety topic area. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Victoria Care Centre on our website at www.cqc.org.uk.

At our last inspection in June 2015 we rated the service as good in the five topic areas; safe, effective, caring, responsive and well-led and in the overall rating.

Victoria Care Centre provides accommodation and personal and nursing care for up to 115 people some of whom may have dementia or physical disabilities. The home is purpose built and located in north west London. Public transport is accessible and there are shops within walking distance of the service.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission [CQC] to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During our focused inspection on the 5 November 2015, we found that the provider had followed their plan. However there were areas where we found shortfalls and legal requirements had not been met.

There were systems in place to keep people safe. We found prompt action had been taken following the incident to make the environment more safe and secure. A protocol was in place for staff to follow to minimise the risk of a similar incident occurring. Communication between staff about peoples’ needs including their behaviour needs had improved since the incident. Further appropriate staff training had taken place. A range of monitoring safety checks were being carried out and improvements made when required.

However, there were some areas of safety that required improvement. The registered person had not fully protected people against the risks associated with their safety as some records including incident records were incomplete, which meant it was not evident that appropriate action had been taken to review them and put specific strategies and guidance in place in place to minimise the risk of them occurring again.

We found adequate systems were not in place to maintain an accurate, complete record in respect of people, including decisions taken in relation to the care and treatment provided. People’s care was recorded in both computer and paper format. Information about aspects of people’s care was not always easy to access as computer and paper care records did not always include the same information, including up to date information which could affect the safe delivery of care to people.

Arrangements were not in place to ensure that staff received specific mental health training to support them in being skilled and competent to care for people who had been admitted to the home with significant mental health and behaviour needs and to keep them safe.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

This unannounced inspection took place on the 16 and 18 June 2015. At the end of the first day of the inspection we told the provider we would be returning on the 18 June to continue the inspection.

Victoria Care Centre provides accommodation and personal and nursing care for up to 115 people some of whom may have dementia or physical disabilities. The home is purpose built and located in north west London. Public transport is accessible and there are shops within walking distance of the service.

At our last inspection in May 2014 we identified concerns in relation to reporting safeguarding concerns, staff training, lack of staff understanding of restrictive practices, referral to healthcare professionals and the provider had failed to notify us of events that affected the service. The registered manager left the service shortly after that inspection, and we received an action plan from the current registered manager. At this comprehensive inspection we found that the required improvements to the service had been made.

There was a registered manager in place, who had managed the home for approximately a year. A registered manager is a person who has registered with the Care Quality Commission [CQC] to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The atmosphere of the home was relaxed and welcoming. People told us that they were happy with the service and had their privacy and dignity respected. They told us they had noticed improvements had been made to the service since the present registered manager had been in post. Our observations and discussion with relatives supported this. Conversations with people’s relatives indicated that they were mostly very pleased with the service provided.

Throughout our visit we observed caring and supportive relationships between staff and people using the service. Staff understood people’s varied and sometimes complex needs. Some staff were particularly kind and had developed a very good rapport with people. All staff interacted with people in a courteous manner. However, some staff engagement with people was reserved and tasked base rather than relaxed and friendly.

Arrangements were in place to keep people safe. People told us they felt safe. Staff understood how to safeguard the people they supported, were familiar with people’s needs and their key risks. People’s care plans contained the information staff needed to provide people with the care and support they needed, however some care guidance lacked clarity and detail.

Medicines were stored and administered to people safely. People were supported to maintain good health. People’s health was monitored closely and referrals made to health professionals when this was required. People were provided with a choice of food and drink which met their preferences and nutritional needs.

Staff received a range of relevant training and were supported to develop their skills and gain qualifications so they were competent to meet people’s individual needs. Staff told us they enjoyed working in the home and received the support they needed to carry out their roles and responsibilities. People were protected, as far as possible by a robust staff recruitment system.

Staff had an understanding of the systems in place to protect people if they were unable to make one or more decisions about their care, treatment and other aspects of their lives. Staff knew about the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People had the opportunity to participate in a wide range of activities of their choice, and were provided with the support they needed to maintain links with their family and friends. Feedback about the service was regularly sought from people, relatives and staff and improvements made in response to this feedback.

There was a clear management structure in the home. People told us the home was well managed. The registered manager was accessible and approachable. People who used the service, staff and people’s relatives felt able to speak to the registered manager and other senior staff when they had any concerns or other feedback about the service.

There were effective systems in place to monitor the care and welfare of people and improve the quality of the service.