Archived: Adey Gardens Care Home

Updated 17 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection started on 25 November 2015 and was unannounced. The inspection team consisted of an adult social care inspector, a specialist adviser and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Further visits were carried out on 26 November 2015 by two adult social care inspectors and on 3 December 2015 by one adult social care inspector.

Before our inspection, we reviewed information about any incidents we held about the home. We contacted the commissioners of the relevant local authority and health authority as well as health and social care professionals to gain their views of the service provided at this home. We contacted the local Healthwatch to obtain their views. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection we spoke with eight people living at the home and six relatives. We spoke with two visiting health care professionals, including a community nurse and a diabetes nurse. We also spoke with a director, the manager, deputy manager, one senior and four care workers, an activity staff member and a cook. We observed care and support in the communal areas and looked around the premises. We viewed a range of records about people’s care and how the home was managed. These included the care records of six people, training records and quality monitoring reports.

Updated 17 February 2016

This inspection took place on 25 and 26 November and 3 December 2015 and was unannounced. At the last inspection of this service in December 2014 the provider had breached a regulation relating to the prevention and control of infection. This was because the flooring in all except one bathroom and in shared toilets had exposed areas of concrete that could not be kept clean. We made a requirement notice about this. The provider wrote to us to say what they would do to meet legal requirements.

During the inspection in November 2015 we found the provider had taken no action to address these concerns. They had failed to replace the flooring to bathrooms or shared toilets. Bathrooms were in a poor state and one bathroom was very odorous. Clinical waste bins were sited near exposed concrete that could not be kept hygienically clean. Lifting equipment used by people (such as hoists) had a layer of debris on the legs and rust on the central column. Clean linen and bedding was stored on the floors in storage cupboards. The small kitchenette on the first floor was dirty and expired food was in the fridge. The laundry room was cluttered, with clothes trailing on the floor and damaged cupboards that could not be kept clean.

Adey Gardens is a two-storey purpose built home which is registered to provide care for up to 37 older people some of whom have nursing care needs. The first floor unit provides 12 places for people living with dementia. Some shared rooms had been converted to single occupancy so the total number of places in the home was 34. At the time of our inspection there were 24 people living at the home.

The home had a manager but they had not registered with the Commission and there had been no registered manager for over one year. A registered manager is a person who has registered with the Care Quality Commission 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.

There had been no routine checks of the safety of the premises, such as hot water temperature checks, since the end of July 2015. This meant the provider could not be sure that people’s health and safety was being protected.

The service did not make sure people’s rights under the Mental Capacity Act (MCA) 2005 were upheld. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’.

The provider had not made sure people were protected by deprivation of liberty safeguards (DoLS). This meant people were being unlawfully restricted because they were unable to leave the home without staff supervision.

Staff training did not include MCA or DoLS so staff were unaware of the impact of this or how to protect people’s rights. The gaps in supervision records indicated that some staff had not received an individual supervision session in the past year.

The care records about people were written in a personalised way but some records were incomplete and some guidance was missing. This meant people might receive care in an inconsistent way.

The provider had not made sure that required health and safety checks were carried out and any actions taken. The provider had not made sure the required six-monthly servicing of hoists and lifting equipment had taken place. This placed people at potential risk of harm.

The provider’s quality monitoring processes were not effective in managing risk or making sure people received a safe service. Shortfalls had been identified at the last inspection but no remedial action had been taken.

People received good support with their health and the staff worked well with community and specialist health services. Visiting health and social care professionals told us the staff were knowledgeable about each person people and were aware of their individual preferences.

People who could express a view, and their relatives, felt the staff were caring and friendly. People described the care staff as “kind” and “helpful”. Staff were caring and compassionate when supporting people. People were assisted in a way that promoted their dignity, and staff valued and respected them.

People and relatives had information about how to make a complaint. People and relatives felt the manager and staff were approachable and that the home had a friendly, welcoming atmosphere.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, they will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

You can see what action we told the provider to take at the back of the full version of the report.