People’s experience of using this service:
• Insufficient staff were employed at the home to meet people’s needs. Due to the high level of care needs of 12 of the 25 people living at the home, the number of staff available during the day and at night was insufficient to ensure people’s needs were met in a timely way. Staff were unable to supervise people to ensure their safety and people were not provided with the opportunity to engage in meaningful leisure and social activity.
• The home was not clean. Some of the furniture in people’s bedrooms and the floors in the communal areas, including bathrooms and toilets, were dirty.
• People’s freedom to walk around the home was restricted with the use of half-height doors placed across hallways. These also posed a safety risk to people who might climb over them. Following this inspection, we were told these had been removed.
• Risks to people’s health, safety and well-being associated with their care needs were assessed and management plans were in place to ensure risks were mitigated as much as possible. However, some improvements were required with monitoring people’s food intake and with the use of equipment used to protect people from skin breakdown.
• Some environmental health and safety checks had not been carried out. These related to the fire safety systems, managing the risk of legionnaires disease and the temperature of the hot water in people’s bedrooms.
• Medicines were being managed safely.
• People told us they felt safe and well cared for at the home. Relatives also expressed their satisfaction with the safety and care provided.
• Staff knew people well and had developed close, caring relationships. We saw people enjoyed being with staff. Staff were aware of their responsibilities to safeguard people.
• Recruitment practices were safe and staff received the training they required for their roles.
• People and their relatives were involved in making decisions about their care.
• Further consideration needed to be given to providing engagement in social and leisure activities for people living with dementia.
• The home was being supported by the local authority to establish more effective quality assurance systems to assess, monitor and improve the safety and quality of the home.
We identified five breaches of the regulations and we made two recommendations for improvement in relation to restricting people’s movement around the home and engaging people in meaningful social activities.
The home met the characteristics of a rating of “Good” for one key question and “Requires Improvement” for four key questions. Our overall rating for the home after this inspection was “Requires Improvement”.
Rating at last inspection: At the last inspection in August 2016 the home was rated Good (report published September 2016).
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Enforcement: Please see the ‘action we have told the provider to take’ section at the end of the report.
Follow up: We have asked the provider to complete an action plan detailing how they will make improvements to ensure the regulations are met. We will work with our partner agencies, including the local authority, to review the progress made in the home. We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk