Archived: High Dene

Updated 22 September 2015

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.

We undertook an unannounced focused inspection of High Dene on 23 July 2015. This inspection was carried out in response to concerns about staffing and people’s safety and welfare. The team inspected the service against three of the five questions we ask about services: is the service safe, responsive and well-led?

The inspection was undertaken two inspectors. During our inspection we spoke with two people who were able to express their views verbally, the relatives of one person and a visiting health professional. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at the care records for seven people. We spoke with three members of care staff and the manager. We looked at records relating to the management of the service, staff personnel and training records, and the systems in place for monitoring the quality of the service.

Updated 22 September 2015

We carried out unannounced comprehensive inspections of this service on 26 January 2015 and 2 June 2015. Both found the service to have serious shortfalls and ongoing breaches of legal requirements including Regulation 12 (care and welfare), Regulation 17 (good governance), Regulation 18 (staffing), Regulation 19 (fit and proper persons employed), Regulation 14 (meeting nutritional and hydration needs) and Regulation 15 (premises and equipment) of the Health and Social Care Act 2008 (Regulated Activities) 2014.

We carried out an unannounced comprehensive inspection of this service on 26 January 2015 and 2 June 2015. After that inspection we continued to receive further information of concern relating to staffing, people’s safety and how the service was being managed. We requested information from the provider to assure us of what action was being taken to safeguard people from harm. The provider was unable to provide us with all of the information requested within the timeframe we set, and this meant we needed to undertake an inspection of the service to look into the concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

The service is registered to provide care for up to 15 people. On the day of our inspection there were 9 people living in the service, some of whom were vulnerable because of their circumstances.

On the day of our inspection the service did not have a registered manager in place. 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 were insufficient staff on duty to meet people’s needs effectively. This meant people had to wait extended periods of time for support from staff, and did not have their social and emotional needs met by staff. Staff did not have the time to complete care records and documentation appropriately.

New members of care staff had started work without having completed the appropriate training. The staff on shift during our inspection did not have the appropriate knowledge, skills and experience to deliver safe care that met people’s needs.

Risks to people were not being appropriately managed. Where risks had been identified by the service, there was no clear guidance for staff on how to minimise the risks and keep people safe.

Care planning for people remained ineffective and did not accurately reflect people’s current needs in sufficient detail.

People were not supported to eat and drink sufficient amounts. Care plans did not set out people’s specific needs in relation to eating and drinking, and records of what people ate and drank were not being completed properly.

People’s health, safety and welfare were compromised because the provider did not have in place a robust quality assurance process to identify issues that presented a potential risk to people. The provider did not have a system in place to ensure that improvements were made in area’s that had been previously highlighted to them.

During this inspection we identified 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 the report.