Archived: Sailaway Residential Care Home

Updated 4 July 2019

The inspection:

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

Why we inspected;

The service is in special measures and is being kept under review. This focused inspection took place on the 24 May 2019 and was unannounced. The inspection was prompted by information given to CQC from the local authority and members of the public. Concerns had been raised about the management of the service and its effectiveness of meeting the needs of people who lived there. The inspection looked at the key question ‘Is the service Well-Led’?.

Inspection team:

The inspection took place on the 24 May 2019 and was undertaken by two inspectors.

Service and service type:

Sailaway is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Sailaway accommodates 18 people in one adapted building. The service has two double rooms currently used for single occupancy. There are bedrooms on the ground and first floors, those on the first floor are served by a stair lift. There is one communal area which is a lounge-diner and leads into a conservatory.

The provider is the manager registered with the Care Quality Commission. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced.

What we did:

We looked at the information we held about the service, as well as information received from the service. We reviewed notifications the provider had submitted. A notification is information about important events the provider is required to tell us about by law.

We did not ask the provider to complete a Provider Information Return (PIR) this is because the inspection was unannounced, and we were responding to information shared with us by the local authority and members of the public. A PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with four staff including the manager and three people who use the service. We looked at records relating to how the service was managed. These included medicine administration records (MAR), staff training, the duty rota and accident and incident records. We reviewed information given to us by the local authority and members of the public.

Updated 4 July 2019

About the service:

Sailaway is a residential care home that provides personal care for up to 18 people aged 65 and over. At the time of inspection 10 people were living at the service, including people living with dementia and people with a learning disability.

People’s experience of using this service:

The registered provider is the person who is usually in day to day charge of the service. They were not present at the inspection on the 24 May 2019 and had been absent from Sailaway since 17 May 2019. The person left in charge during the provider’s absence is referred to in this report as ‘the manager’. This person was not registered with the Care Quality Commission and was not legally responsible for how the service is run or for the quality and safety of care provided.

During periods of their absence from the care home, the registered provider did not leave a suitably qualified and competent person in charge. The manager left in charge did not demonstrate an understanding of the knowledge and skills required to manage a care home. The manager did not demonstrate competencies in the overall management of the service and was not fit and competent to be in charge due to their personal conduct and failure to improve the service.

Aspects of leadership and governance of the service were not effective in identifying some significant service shortfalls, such as failing to ensure staff were appropriately trained and skilled to undertake aspects of their role.

The provider was not always delivering the appropriate level of support that people were assessed as requiring to meet their needs and keep themselves and others safe.

Incidents were not always responded to, recorded or addressed appropriately.

Records were not always kept about persons employed or the management of the regulated activity.

The registered provider had not ensured that there were always suitably trained and competent staff on duty to administer medicines.

The provider had not ensured a process to implement or sustain the improvements that they told us that they were going to make. There was a lack of improvement to the service people received.

Rating at last inspection:

The last inspection the service was rated as Inadequate. (published 16 May 2019)

Enforcement;

At the last inspection on 20 and 26 February 2019 and 10 April 2019, report published 19 May 2019, the service met the characteristics of inadequate in three key questions, Safe, Effective and Well-Led and requires improvement in two key questions; Caring and Responsive. Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded. We are taking enforcement action and will report on this when it is completed.

Follow up:

The overall rating for this service remains ‘Inadequate’. This means that it remains in ‘special measures’. We will keep the service under review and, if we do not propose to cancel the registration we will re-inspect within 6 months to check for significant improvements.

The purpose of special measures is to:

Ensure that providers found to be providing inadequate care significantly improve.

Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question overall, we will act 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 overall, we will act to prevent the provider from operating tis service. This will lead to cancelling the providers registration or to vary the terms of their registration.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded. We will have contact with the provider following this report being published to discuss how they will make changes to ensure the service improves their rating to at least Good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk