Lower Bowshaw View is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The care home accommodates 40 people in one building. The home is located in a residential area of Sheffield with access to public services and amenities.
The home was last inspected on 3 January 2017 at which time it was rated overall as requires improvement. There were no breaches of the regulations identified during the inspection, but some improvements were required. Some infection prevention and control practices did not always promote people's safety, staff did not always support people to eat effectively and some quality assurance and audit processes were ineffective.
At this inspection we found that sufficient improvements had not been made to these areas and we found there was now a breach in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 15,Premises and Equipment, Regulation 14, Meeting Nutritional and Hydration Needs and Regulation 17,Governance. We also found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014,Regulation 18,Staffing,Regulation 10,Dignity and respect and Regulation 9, Person centred care.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
This inspection took place on 31 October 2017 and was unannounced. This meant the people who lived at Lower Bowshaw View and the staff who worked there did not know we were coming.
There was a manager at the service who was registered with the CQC. 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 and associated Regulations about how the service is run.
The numbers and deployment of staff were not appropriate to safely meet the needs of people who used the service.
People were not consistently cared for in a safe and clean environment.
Some people’s nutritional needs were not being met. Meal times were not appropriately spaced and some people were not eating for long periods of time.
Although some people and their relatives told us that staff treated people with kindness and were caring, we saw a number of examples where this was not the case and some people’s privacy and dignity were not upheld.
We found people did not always receive care in a person centred way. This was because the deployment of staff meant staff's approach was mainly task and routine focused, which did not take into account people’s own preferences.
Staff were aware of safeguarding procedures and knew what to do if an allegation was made or if they suspected abuse. People told us they felt safe.
We found systems were in place to make sure people received their medicines safely so their health was looked after.
Staff had regular updates to their training and were provided with relevant supervision and appraisal so they had the skills and support they needed to undertake their role.
Staff recruitment procedures ensured people’s safety was promoted.
The service followed the requirements of the Mental Capacity Act 2005 (MCA) code of practice and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice.
People had access to a range of health care professionals to help maintain their health.
People and their relatives were confident in reporting concerns to the registered manager and felt they would be listened to.
Staff told us the registered manager was supportive and communication was good within the home.
There were quality assurance and audit processes in place to make sure the home was running safely. However these were not effective or acted upon to ensure care provided was adequately monitored, risks were managed safely and the service achieved compliance with the regulations.
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.
You can see what action we told the provider to take at the back of the full version of the report.