7 July 2016
During a routine inspection
The service has a registered manager. 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.
The provider did not have robust systems in place to ensure that people were safe. The recruitment process was poor and the provider did not carry out the required checks before an offer of employment was made. Risk assessments did not provide guidance for staff on how to mitigate the risks when providing care and support to people who used the service. Relevant information about safeguarding procedures was not available to people and members of staff so that they could raise safeguarding concerns to the appropriate authorities. There were unexplained gaps in medicine administration records and staff had not had a competency assessment done to ensure that they were competent in the management and administration of medicines.
Staff had not received the relevant training for the work they did. Not all staff had received regular supervision and appraisals. None of the staff had any competency test carried out to establish whether they had the required skills, and experience for the work they did.
People were positive about how their care was managed by the care staff. They were treated with kindness and compassion. People were treated with respect and their privacy and dignity was promoted.
People’s care needs had not been thoroughly assessed, reviewed and delivered in a way that promoted their wellbeing. The care plans lacked detailed information and they were not person-centred. There was a complaints procedure in place.
The provider did not have effective quality monitoring processes in place to drive continuous improvements. There were no effective systems in operation to seek the views of people in a formalised way and to assess and monitor the quality of service provision.
The overall rating for this service is ‘Inadequate’ and the service is therefore 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, and if there is not enough improvement so there is still a rating of inadequate for any key question 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.
We found seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking enforcement action against the registered provider. We will report further on this when it is completed.
You can see what action we told the provider to take at the back of the full version of the report.