Archived: Thomas Leigh Care Home

Updated 2 December 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.

Before this inspection we were made aware of a serious incident that had occurred in the home which had resulted in a safeguarding alert and police investigation.

This inspection took place on 29 and 30 September 2016, 13 October 2016 and 20 October 2016, this inspection was unannounced.

The inspection team consisted of one adult social care inspector an adult social; care inspection manager and a specialist professional advisor (SPA). The SPA was a registered nurse with experience of the care of people with dementia.

Before the inspection we asked for information from the local authority and we checked the website of Healthwatch Liverpool for any additional information about the home. We reviewed the information we already held about the service and any feedback we had received.

During our visits we spoke with five people who used the service, two people’s relatives and five members of staff. We observed activities in the lounge and lunchtime in the dining room. We looked at care notes for seven people who used the service, medication storage and records, 11 staff records, accident and incident report forms, health and safety records, complaints records, and other records for the management of the home.

At the time of the inspection there were 48 people living at the home and 50 staff employed.

Updated 2 December 2016

Thomas Leigh is located in the Knotty Ash area of Merseyside and is registered to provide care and accommodation for up to 54 adults. The home could accommodate 19 people for nursing care and 35 people for residential care. At the time of our inspection 17 people were receiving nursing care and 31 people residential care.

The service is provided in a purpose built building. Accommodation is provided over two floors and the first floor can be accessed by stairs or passenger lift.

The home had a registered manager. 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.’ The registered manager was in attendance throughout the inspection.

During our inspection, we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulated Activities 2014 in respect of Regulation 9 person centred care; 12 safe care and treatment; 13 Safeguarding service users from abuse; 17 good governance and 19 fit and proper persons employed, of the Health and Social Care Act 2014 Regulations. You can see what action we told the provider to take at the back of the full version of the report.

People received support with their health care. However care plans had not been updated accurately and contained guidance that if followed would pose a risk to people's health and safety. Risks to people's safety were not acted upon in a timely manner. Systems and processes for reporting potential abuse and keeping people safe did not work effectively and concerns had not been reported to the local authority or to CQC as required. Plans had not been put in place to manage identified risks to people’s safety. Quality assurance systems were not effective regarding care planning and risk assessment systems.

There was no evidence that the services disciplinary policies and procedures had been appropriately followed and recruitment processes of staff did not effectively ensure new staff were recruited safely.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. 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.

The service will 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 we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location from the providers registration.

People we spoke with told us they felt safe at the home and they had no worries or concerns. People’s relatives and friends also told us they felt people were safe. The staff at the home knew the people they were supporting and the care they needed. We observed staff to be kind and respectful towards people. The home provided a range of activities to occupy and interest people.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been adhered to in the home. The provider told us the majority of people at the home lacked capacity and that a number of Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority in relation to people’s care.

Infection control standards at the home were good and these standards had been monitored and managed.