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Archived: The Old Rectory Inadequate

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Inspection report

Date of Inspection: 26, 27 June 2014
Date of Publication: 9 August 2014
Inspection Report published 09 August 2014 PDF

Overview

Inspection carried out on 26, 27 June 2014

During an inspection in response to concerns

The inspection team was made up of four inspectors. We visited the service over two days.

We spoke with the people who used the service, the provider, the deputy manager, the head of care and care staff. We also observed staff supporting people with their daily activities.

The Old Rectory can provide accommodation for up to 40 people who have a learning disability. There were 37 people using the service at the time of our inspection.

We considered our inspection findings to answer questions we always ask:

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well-led?

This is a summary of what we found. This summary is based on our observations during the inspection, discussions with people using the service, staff supporting people and the management team:

Is the service safe?

The service was not safe. There were no systems in place to make sure that the staff learned from accidents and incidents.

When people had accidents the most appropriate and safe action was taken to make sure they received the treatment they needed.

Assessments were not undertaken to ensure that people received safe and appropriate care.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. The relevant people were consulted with regard to people�s mental capacity and the deprivation of people�s liberty was taken into account.

People using the service told us that they felt safe.

Care and support plans detailed each person�s individual needs. When risks to a person were identified the home carried out a risk assessment. However, care plans relating to continence needs were not always followed by staff.

Recruitment processes were not safe. This was because there were not robust procedures in place. There was no evidence that potential risks had been assessed when people had criminal convictions or poor references. The provider had not taken action to protect people who used the service from risks posed by staff that were not honest or of good character.

Is the service effective?

The service was not effective. Some care and support plans referred to out of date information so were not current.

Staff had not filed some people�s records correctly so they were not easily accessible. There were loose documents and paperwork which could get lost or damaged.

Some people were unable to communicate verbally and used signs and gestures. Staff were able to tell us what signs were displayed if someone was agitated and what they could do to reassure them. We observed staff communicating effectively with people throughout our inspection.

The provider did not operate an effective system to regularly assess and monitor the quality of the service provided. The service had a complaints process in place and information had been given to people about how to make a complaint. The easy read version of this process had recently been updated, but had not been shared with people using the service.

There were no structured systems in place to ask relatives and staff for their views about the service. There were no staff meetings. This meant that people's representatives and staff did not have opportunities to air their views and opinions.

Is the service was caring?

The service was caring. People were supported by kind and attentive staff. Staff showed patience and gave encouragement when supporting people. People we spoke with said they felt staff respected their privacy and dignity and said that staff were polite and caring. People we spoke with said they liked the staff.

We found that people were supported to attend health appointments, such as, doctors or dentists. We saw records to show that the service worked closely with health and social care professionals to maintain and improve people's health and well-being. However, we found that action was not always taken when recommendations had been made by health professionals.

We saw positive interactions from staff when supporting people throughout our inspection.

Is the service responsive?

The service was responsive. People told us that they were happy with the service. It was clear from observations and from speaking with staff that they had a good understanding of the people's care and support needs.

We saw records to show that the service worked closely with health and social care professionals to maintain and improve people's health and well-being.

Staff were attentive to people using the service and responded promptly when needed.

Regular meetings were held with people who use the service to express their views on the day to day running of the service. However, there was limited participation with people who were less assertive or who had communication difficulties.

Is the service well-led?

The service was not well led. The provider was not in day to day control of the service.

There was a management structure in place. The provider and the management team knew about some of the shortfalls at the service but no action was taken to address these. They did not take responsibility for things that happened in the service and did not implement changes to address the shortfalls and concerns.

The provider did not operate an effective system to regularly assess and monitor the quality of the service provided. This meant that the people could not be confident that their health, safety and welfare would be protected.

Audits of the care plans and other systems used at the service had been not been completed to assess the quality of the care being provided. The service had not identified the shortfalls in the care plans found at the inspection. Therefore the systems in place to audit the care plans and risk assessments was not effective to make sure people were receiving the care they needed.

Staff told us they were clear about their roles and responsibilities and that they felt supported by the management team.