Archived: Mr and Mrs O'Donnell Also known as The Red House

Our inspection took place on 8 & 9 June 2016 and was unannounced. At our last inspection in October 2014, we rated the provider as Good. Since our last inspection, the composition of the partnership responsible for this service has changed. We are currently in the process of resolving queries around this provider’s registration. Where we refer to the ‘provider’ in this report, this refers to the person currently providing the regulated activities whilst the issues around the current registration are resolved.

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.

The home did not have 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.

People did not receive safe care. Support was not always provided in a safe way to ensure people’s well-being. Staff were aware that care practices at the home were unsafe but had not taken action to safeguard people. Risks to people were not identified or managed to ensure that people were kept safe.

There were insufficient staff available throughout the night. People did not have access to staff should they require support during this time and had no means to call for support. People who required support to go to bed had to go to bed before day staff left as there would be insufficient staff to help them following this point.

Staff employed by the service had not undergone the appropriate checks to ensure they were safe to work. People who were not employed by the service had access to all areas of the home without having the appropriate checks made. Staff had not received appropriate training or support to ensure that they were competent in their role.

People were not supported to make their own decisions in line with the Mental Capacity Act 2005. We saw that some people were being deprived of their liberty without the provider applying for authorisation to do this.

The provider had failed to ensure that people were given choices with regards to their meals. People were not asked what they would like to eat at mealtimes or given a choice about where they would like to eat their meals. Where people had specific dietary requirements, these were not met.

People were supported to access healthcare services to maintain their health and well-being but this was not always sought in a timely way. Where guidance had been issued by a healthcare professional to maintain people’s health, this was not followed by staff or the provider.

Staff and the provider had not always ensured people were given choices, treated with dignity and supported to maintain their independence. There were no systems in place to ensure people could access advocacy services if required.

People and their relatives were not involved in reviews of their care. Where people’s needs changed, this was not documented or made clear to staff how this would affect how they should support the person.

There were no records of complaints made and people told us they had not been made aware of how they could do this if they chose to. People were given questionnaires to provide feedback on the service but where suggestions were made, these were not acted upon.

There were no systems in place to monitor the quality of the service. The provider did not have an understanding of the Heath and Social Care Act 2008 regulations or their legal responsibility to meet these.

You can see what action we told the provider to take at the back of the full version of the report.

Following the inspection, we shared the concerns we had with Dudley local authority and West Midlands Fire Service.

People were encouraged to make decisions about their everyday lives. Where people did not have the capacity to make certain decisions they were made in the person's best interests as required by law.

We saw that people chose to be cared for in their bedrooms where they had all their meals. All had weekly visits from relatives. Some were visited several times each week. People using the service all regularly saw an independent advocate. We saw that people's care needs had been assessed and care records contained detailed information about how they wished to be supported.

Systems were in place to monitor nutrition and people's daily intake of food and fluid. People using the service and relatives talked about "High quality home cooking". People had a positive dining experience.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The home provided a traditional, comfortable and homely setting for people. Checks were in place to maintain a safe environment.

We saw that people were well presented and wore clothes that reflected their own preferences and style. We saw staff promoted people's independence, privacy and dignity in different ways. One person said "I can go to my room whenever I want".

We found that care records provided an overview of people's lifestyles and history. We saw staff caring for people in a person centred way. One relative told us "Nothing is too much trouble, its caring care".

We found that arrangements were in place to ensure that people were safeguarded from harm. Relatives we spoke to told us they felt their relative was safe living in this home.

Staff felt they were well supported and training was available as part of the knowledge/skills needed to deliver services. We saw that appropriate checks had been made to ensure that staff were suitable to work with vulnerable people.

We found that there were some systems in place to monitor the quality of the services, and make improvements where required.

We found that people knew how to complain, although all the people we spoke with did not have any concerns.