Background to this inspection
Updated
14 December 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by two inspectors.
Service and service type
Hadley Place Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
There was no manager registered with CQC at the time of our inspection visit. The previous registered manager had left the service in February 2018. The manager had applied for registration and had not been successful. It is a legal requirement to have a registered manager. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced from the car park of the service on the first day of inspection. We did this to discuss the safety of people, staff and inspectors with reference to Covid-19. We told the manager we would be returning on the second day.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with five people who used the service and one relative about their experience of the care provided. We spoke with eleven members of staff including; the manager, the assistant manager, the administrator, three care staff, two senior care assistants, two housekeepers and the cook.
We reviewed multiple people's care files, daily records of care and medication records. We also reviewed one staff personnel file. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We conducted a walk around of the service and spent time observing staffs’ interactions with people as well as staffs’ infection prevention and control practice.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at surveys and dependency records. We spoke with a professional and three relatives.
Updated
14 December 2021
About the service
Hadley Place Residential Home is a care home providing personal care for up to 29 older people who may be living with mental health needs or dementia. The service was supporting 20 people at the time of our inspection.
People’s experience of using this service
People were at risk of harm as risks to their health, safety and wellbeing were not effectively identified and managed. There remained widespread and significant concerns about the quality and safety of the service, which had not been addressed since our last inspection.
The service was unclean and not properly maintained. Risks associated with the environment had not been addressed in a timely way to help keep people safe. Robust systems were not in place to ensure the service was regularly and thoroughly cleaned or to effectively reduce the risks of people catching and spreading COVID-19.
People raised concerns about staffing levels, the provider’s dependency tool did not provide assurances that staffing levels were effectively monitored. Appropriate fire drills had not been completed to check and make sure night-time staffing levels were safe and people could be safely evacuated if there was a fire at night.
Accidents and incidents were not effectively reported, recorded and responded to. This put people at increased risk of harm.
People received their medicines as prescribed, but further improvements were needed to ensure medicines were consistently managed and administered safely.
Robust systems were not in place to check and make sure all staff were suitably trained and competent.
People’s needs were not robustly assessed and regularly reviewed. Care plans and risk assessments did not always reflect people’s needs, risks or provide up-to-date information to guide staff on how to safely support them.
People were not consistently supported to have maximum choice and control of their lives and staff did not support them in the least restrictive ways possible and in their best interests; the policies and systems in the service did not support this practice.
People did not receive person-centred support to engage in regular meaningful activities to reduce the risk of social isolation. Any wishes or views people had for their care and support approaching the end of life wishes were not always explored and recorded.
The service was not well-led. There were continued widespread concerns about the quality and safety of the service. The provider had failed to take sufficient and timely action to address safety issues and to make improvements, which would help keep people safe and improve their quality of life. There was a lack of effective oversight and governance.
For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.
Rating at last inspection and update
The last rating for this service was inadequate (published 8 June 2021) and there were multiple breaches of regulation.
At this inspection not enough improvement had been made and the provider was still in breach of regulations. The service remains rated inadequate. This service has been rated requires improvement or inadequate overall for the last five consecutive inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at our last inspection.
Enforcement
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We identified breaches in relation to person-centred care, dignity and respect, consent to care, safe care and treatment, the environment, staffing, and the provider’s governance arrangements. Please see the action we took at the end of this report.