Archived: Integrated Care Services Limited - 27a Old Kenton Lane

We took out enforcement actions in response to these breaches and issued warning notices as required within the Care Quality Commission enforcement policy.

Regulation 9(1)(a)(b)(i)(ii)

The registered person did not take proper steps to ensure that people who used the service were protected against the risks of receiving care or treatment that was inappropriate or unsafe, by means of the carrying out of an assessment of needs and risks of the service users and the planning and delivery of care in such a way as to meet the service user's individual needs and ensure the welfare and safety of service users.

Regulation 10(1)(a)(b)(2)(e)

The registered provider did not protect service users, and others who may be at risk, against the risks of inappropriate or unsafe care, by means of the effective operation of system designed to enable the registered person to regularly assess and monitor the quality of services. The registered provider did not seek the views of services users, persons acting on their behalf and persons who were employed to enable the registered person to come to an informed view in relation to the standard of care and treatment provided to people who used the service.

On 30 August 2014 we received an action plan confirming that the provider had taken steps to become compliant with Regulation 9(1)(a)(b)(i)(ii) and Regulation 10(1)(a)(b)(2)(e) of the Health and Social Care Act 2008 (Regulated Activities) 2010.

The purpose of our inspection on 18 September 2014 was to assess compliance with the breaches of Regulation 9(1)(a)(b)(i)(ii) and Regulation 10(1)(a)(b)(2)(e) of the Health and Social Care Act 2008 (Regulated Activities) 2010.

We looked at three care records, spoke with one person who used the service, observed staff interactions with people who used the service, spoke with the two care workers, the registered manager and the registered provider. We found that the provider had taken appropriate steps and updated care records, risk assessments and prescribed as required (PRN) medicines guidance for people who used the service. Action had been taken to assess peoples capacity to make decisions in line with the requirements of the Mental Capacity Act 2005.

People who used the service, relatives and care staff were sent a satisfaction questionnaire and action had been taken to make improvements in response to the feedback received. Regular quality monitoring systems had been implemented and care workers and people who used the service were invited to participate and contribute to regular meetings. Fire safety had been assessed and steps had been taken to rectify shortfalls within the fire safety of the home.

However, we found evidence that the provider was still in breach of regulation 9 and 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. As a result of these breaches we have taken enforcement action against the provider.

A single inspector carried out this inspection. . 27a Old Kenton Lane is a residential home for four people with learning disabilities. The focus of the inspection was to answer the five key questions: is the service safe, effective, caring, responsive and well-led?

Is the service safe?

Staff received training in how to respond and recognise abuse. Risks to people who used the service were not always assessed and the provider had failed to put measures into place in how to reduce risk and provide safe care.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have been submitted, appropriate policies and procedures were in place.

Is the service effective?

Care plans provided were not always fit for purpose and did not document peoples changing needs in their mobility and how to respond appropriately to challenging behaviours. We found a lack of guidance for staff in relation to as and when required medication and in response to risks of choking.

Is the service caring?

We observed that care workers asked people who used the service for their consent prior to providing care and support. (Staff had received training in the application of the Mental Capacity Act (MCA) 2005 and systems were in place to follow the requirement of the MCA.

Is the service responsive?

The service had not carried out a survey asking people who used the service, their representatives and staff for their views about the home. Audits of the service had not been carried out. This meant that the provider was not able to respond swiftly to any changes in the quality of care and support provided to people who used the service.

We found that since our last inspection on 31 January 2014, the provider had reviewed and updated peoples care plans, but failed to respond appropriately to peoples changing health needs.

Is the service well-led?

The provider did not have formal systems in place to monitor and assess the quality of care provided and did not obtain feedback from people who used the service, their representatives or staff. This meant that the provider was not able to recognise changes in the provision to the care provided and was unable to respond swiftly to such changes.

While regular safety checks of fire systems were in place, there was a lack of regular audits of Health and Safety, medicines administration and the environment. This put people at risk of being supported in an environment which was not conducive to the provision of safe care.

We found that the provider did not obtain consent prior to care and support, and that support provided did not ensure people's safety and welfare. We saw that the provider worked in cooperation with other service providers, however this was not appropriately documented.

We saw that people were supported to receive nutritious and varied food and drink, and that the service was cleaned to a high standard.

We found that staff were appropriately checked before they started work, however they were not qualified for their roles. We saw that records were incomplete, out-of-date and not fit for purpose.

At the time of our visit, the provider had recently undergone a significant change to their circumstances which had a great impact on the service. For this reason, we gave the provider additional time to supply us with evidence of compliance with the Regulations.

People approached staff without hesitation and staff supported people in a friendly, sensitive and professional manner. Staff knew about their roles and responsibilities in meeting the needs of people.

People's preferences and goals were considered in relation to the care and support that they received. People received treatment and advice from a variety of health and social care professionals.

We saw people took part in a range of leisure activities and their independence and skills were promoted and supported by staff.

The policies that were in place and the training received by staff protected people from abuse. Staff received the training they needed to meet people's varied needs.

We spoke to two relatives of people using the service, who were positive about the care provided by the home.