Background to this inspection
Updated
9 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
The inspection was prompted due to potential concerns about the management of risk and staffing levels at the home. We decided to complete a focused inspection. This inspection examined those risks.
This inspection took place on 08 January 2018 and was unannounced. The inspection team consisted of two inspectors.
As part of the inspection, we reviewed the information we held about the service, including statutory notifications. A statutory notification is information about events that by law the registered persons should tell us about. We also asked for feedback from the commissioners of people’s care to find out their views about the quality of the service. We also contacted the local authority safeguarding team for information they held about the service. We used this information to help us plan our inspection.
During the inspection, we spoke with four people who lived at the home and three visitors or family members. We spoke with the registered manager, the provider and an external consultant. We also spoke to eight members of staff. We carried out observations throughout the home to help us better understand the experiences of people living at the home to review the quality of care people received. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at four care records for people. We also looked at other records relating to the management of the service including staff files, accident reports, audit records and four medicine administration records.
Updated
9 March 2018
We undertook this unannounced focused inspection of C&V Residential Limited on 08 January 2018. This inspection was prompted in part by information shared with CQC about the potential concerns around the management of people’s care needs and a number of notifications received about people sustaining injuries at the home. This inspection examined those risks. Prior to this inspection we carried out an unannounced focussed inspection of this service on 08 November 2017. Breaches of legal requirements were found and we took the decision to use our enforcement powers. We will report on this once it is complete. Previous to this we completed a comprehensive inspection of this service in September 2017. Following this inspection we used are urgent enforcement powers and restricted admissions into the home and imposed conditions on the provider’s registration. We required people’s risk assessments to be updated and reflective of people’s needs along with assuring adequate numbers of qualified trained staff were deployed effectively across the home. This was because people were at risk of harm. At this inspection we found the provider continued to not meet the requirements of the law and sufficient improvements have not been made.
At this inspection the team inspected the service against two of the five questions we ask about services: Is the service well led and is the service safe. This is because the service was not meeting some legal requirements. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.
At our September 2017 inspection we gave the location a rating of ‘inadequate’ and entered it into special measures. We identified seven breaches of the Health and Social Care Act (HSCA) 2008 and one breach of the Care Quality Commission (Registration) 2009. At this inspection we found the provider continued to be in breach of the HSCA regulations. You can see what action we told the provider to take at the back of the full version of the report.
C & V Residential Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates people in one adapted building. C & V Residential Limited accommodates 32 people, some were living with dementia. At the time of the inspection there were 22 people living at the home.
The home currently has a registered manager 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People did not have their needs met in a timely manner because there were not enough staff nor were they effectively deployed across the home. Staff did not have the skills and knowledge to meet people’s needs effectively. People were not protected from the risk of harm because staff did not understand how to manage people’s individual risks to keep them safe. People did not always receive their medicines as prescribed and people’s nutritional needs were not always being met. The recruitment system operated by the provider needed to be improved to ensure staff were suitable to work with the people living at the home.
Staff had not received adequate training nor had their competencies checked to ensure care provided to people was safe and effective. The care people received was not always responsive to their own individual needs. People had mixed views about whether the service was well led. People were not protected by a quality assurance system that identified areas of improvement needed to ensure people received safe effective care. The provider continued to fail to recognise and improve the quality of care being provided to people. Staff did not have effective leadership which meant people were not protected from risks to their health, safety and well-being.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action 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. If there is not enough improvement so there is still a rating of inadequate for any key questions or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.