Background to this inspection
Updated
13 March 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.
This inspection took place on 3 & 11 November 2014 and was unannounced. The inspection team consisted of two inspectors.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider completed and returned the PIR to us and we used this information as part of our inspection planning.
Prior to and during the inspection we spoke with the local safeguarding team who had highghted concerns around people’s food and drink and they told us they were monitoring people’s dietary needs, and had sought further support and advice from speech and language therapists.
We also looked at other information that we held about the service including notifications. Notifications are important events that happen in the service that we are required to be informed about by law. We also contacted the local authority safeguarding team for their views on the service.
During the inspection we spoke with four people who used the service, the registered manger, the provider, the deputy manager, five staff and two visiting health professionals. We undertook general observations in communal areas and during mealtimes. We looked at the interaction between staff and the people living at the home.
We looked at four people’s care plans and other records related to their care such as medicines administration records. We looked at records relating to the management of the home including staff meeting minutes, service user quality assurance survey questionnaires, staff recruitment files and training records.
Updated
13 March 2015
This inspection was carried out on 03 and 11 November 2014. It was an unannounced inspection and was undertaken by two inspectors. The previous inspection was undertaken on 30 May 2013 and during this inspection we found that all of the regulations we looked at were being met
Chatting Independently-Orchard View is registered to provide accommodation and personal care for up to six people who have physical disabilities. People are accommodated on two floors which are accessed by a lift.
A registered manager was 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
During this inspection staff treated people in a way they liked and there were sufficient numbers of staff, although they did not all have the required skills to safely meet people’s needs.
People were not protected from abuse because staff were not clear of the reporting procedures should they have any concerns about people.
People’s needs were not clearly recorded in their plans of care which meant that staff did not have the information they needed to provide care in a consistent way. Care plans were not regularly reviewed to ensure that they accurately reflected people’s current needs.
Most people spoke positively about the quality of food at the home. However, people were not provided with a diet that met their needs. Appropriate risk assessments were not in place in respect of eating and drinking and this put people at an increased risk of choking. People were not always appropriately supported with their eating and drinking at mealtimes.
The provider’s monitoring and audit processes were ineffective and inadequate and had failed to identify issues in the home. Risks to people’s health, safety and welfare were not appropriately assessed and managed.
Staff had not been provided with training opportunities to ensure they had all the required skills to carry out their roles.
There was a lack of an effective quality assurance system in place to monitor the service and ensure people received good quality care.
Our concerns about the safety and welfare of people were so great that we immediately informed the local authority of these concerns. As a result of our concerns the commissioners decided to remove all people from this home on 14 November 2014.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.