Archived: Leopold Muller Home

About the service

Leopold Muller Home is a residential care home providing personal and nursing care for up to 22 people who are Deaf or deafblind. People often have a range of other complex needs including dementia, mental health, a learning disability and/or autism. At the time of the inspection up to 15 people were living at the home. One person was at the home on respite.

The home is over three floors and has lounges with kitchenettes on the first two floors. There was an activity space on the first floor and a dining room on the ground floor. Individual bedrooms were on each floor.

People’s experience of using this service and what we found

People who were not autistic and/or had a learning disability were not kept safe or had their needs met at this home. Medicines were not always managed safely and risks were not always considered or mitigated. There were not enough staff supporting people with adequate communication skills.

People were able to access other professionals when their health declined. However, this was not always in a timely manner. Systems were not in place to help people make choices who lacked capacity. The provider and management systems were not identifying concerns found during the inspection. Neither were they ensuring people’s care was in line with current legislation, guidance and laws.

Right Support:

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The model of care was not in line with current best practice. There was a focus from staff on encouraging people to eat at the same time in a dining room. Kitchen staff prepared the meals and there were limited opportunities for people to work towards independence, such as cooking for themselves.

People were not supported by enough staff who had adequate training to communicate effectively with them. The provider had not put systems in place to mitigate this risk and impact was identified to some people as a result. The environment was dated and in places damaged which the provider had plans to rectify.

Right Care:

People were not always treated with dignity and respect by staff. Occasions were witnessed throughout the inspection which illustrated this. Staff tried to interact with people in a caring way and there were key staff who promoted this. However, many times through the inspection undignified care was witnessed often due to a lack of understanding of people’s needs. Examples seen was staff shouting down the corridor at each other about people’s intimate care. Also, leaving doors open when delivering intimate care.

The activity coordinator did their best to involve people in games and group sessions. However, these were limited due to their availability and lacked support from staff with communication skills to assist. No people actively took part in their local community and no one was seen leaving the home during the inspection.

Right Culture:

People were not leading confident, inclusive and empowered lives at the home. Many people sat in rooms with little to no interaction between tasks that were required. Little respect was shown for people being part of the Deaf and deafblind communities. There was a lack of cultural opportunities for them.

The management at the home did their best to lead by example and we received positive feedback about them. However, they were unable to complete many of their management tasks due to supporting a large unstable staff team. The new provider had not updated their governance systems to take on a nursing home or services for people that were Deaf and deafblind.

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

Rating at last inspection

This service was registered with us on 30 June 2021 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 5 December 2018.

Why we inspected

The inspection was prompted in part due to concerns received due to a change in provider and concerns around leadership, people’s cultural needs being met and staffing. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to keeping people safe including from risks of harm and potential abuse. Breaches have been found related to staffing and staff training, people’s dignity and culture, infection control, medicine management, personalised care and governance of the home at this inspection.

Following the inspection, the provider informed us they were going to slowly close the home making sure people’s needs and preferences were considered at all stages.

Follow up

We will meet with the provider and request an action plan of how they will keep people safe following this report being published to discuss how they will be proceeding with the closure of the home. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service until it is closed.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if the provider has not closed the home, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement or closed the home within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.