29 September 2016
During a routine inspection
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.