Archived: The Dales

When we visited again in January 2014 we found that safeguarding training had still not been provided for staff. Restrictions, placed on people's freedoms to manage risks, had not been officially authorised. Some record keeping had improved but others had not. Systems to recruit staff did not provide sufficient safeguards to protect people. We determined that issues of non-compliance with regulations were ongoing and had not been adequately addressed.

In February 2014 the provider informed us that she intended to retire and close the home. We kept in contact with the local authority that was making alternative arrangements for people's care.

We visited again on 28 March 2014 and found that people's needs assessments and care plans were not updated and some plans were not being followed. This put people at risk. No safeguarding or mental capacity training had been given to staff and most record keeping systems had fallen into disuse. A few days after our visit a safeguarding referral from a local hospital was shared with us by social services. A person who used the service had an unplanned admission to hospital. They had missed some regular checkups for long term health conditions because the home had not re booked appointments that were missed when they felt too unwell to attend.

On our visit of Saturday 4 January 2014 people told us that they liked living at the home and staff supported them with their daily lives. People looked well groomed and relaxed with staff. People had written plans of care that were individual to them although not all recently reviewed. Assessments addressed many risks presented by people's needs. Staff acted on changes in people's physical health or well-being and had the support of community health care staff.

We found no improvement in safeguarding practice. Measures were in place to minimise the risk to people of financial exploitation but these were not supported by any formal assessment or official agreement. Staff remained without updated training in safeguarding and new staff had little understanding of it.

Staff recruitment systems were not robust and training was largely out of date. Staff received no professional support by way of individual supervision and appraisal. New staff had no formal induction training and there was no plan to develop staff skills.

Record keeping had improved but many were not kept up to date, not stored properly or could not be located when we asked for them.

We found that the provider still had no systems for monitoring or assessing the quality of the service and this meant that some risks were not being identified and managed.

We found the provider and staff had limited understanding of proactive measures to safeguard people from risk of abuse. Professional judgement was not being exercised or sought and training was not up to date. Some people were at risk of financial mismanagement.

People benefitted from being cared for in a clean, hygienic environment and risk of infection was managed.

There was a well- established staff group that included members of the provider's family and an effective recruitment procedure was in place. People told us that they liked the staff that supported them and we observed that people looked comfortable with staff.

We found the provider had a quality assurance system in place but it was not effective. Shortfalls in the service were not identified and put right.

Health records made in conjunction with visiting professionals were kept in good order and some regular safety check records were kept up to date. However, many records were poorly kept and not available when we asked to see them.