Archived: Rainbow Homes London Limited

Updated 13 October 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 02 September 2015 and was unannounced. The inspection team consisted of an inspector and a specialist professional advisor who specialised in food and diet of people with mental health needs.

Before the inspection visit we reviewed the information we held about the service including notifications, information from the local authority, and information the provider had sent us.

During this inspection we spoke with two people who use the service, three staff members and the registered provider’s director. We watched the care and support being provided to people in communal areas, and looked around the premises. We reviewed all three people’s care records that lived at the service and looked at records relating to staff employment, training and support, and the management of the service.

After the inspection we obtained the views of four community professionals involved in working with people using the service. The service’s management team also provided us with further documents at our request.

Updated 13 October 2015

The company Rainbow Homes London Limited operates this one care service that is registered with the Care Quality Commission. The services provided at this care home include for people with mental health conditions or substance misuse problems, and is primarily aimed at younger adults. The care home is for up to six people. There were three vacancies at the time of our inspection.

We carried out a comprehensive inspection of this service on 10 December 2014. We found eight breaches of legal requirements, which put people using the service at significant risk of receiving inappropriate or unsafe care. You can read the report of this inspection, by selecting the 'all reports' link for this service on our website at www.cqc.org.uk

We took enforcement action against the registered provider as a result of the findings of that inspection.

We undertook this unannounced comprehensive inspection, of 02 September 2015, to check on the progress the provider had made to address our concerns from the previous inspection, and to check on the standard of care people using the service were receiving.

There was no registered manager in post on the date of the inspection visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. A new manager had been appointed. They had applied for registration as manager of the care home; however, this process had not been completed. They were not present during out inspection visit.

Whilst we found evidence to demonstrate that some of our concerns had been addressed, we found breaches of 12 legal requirements because improvements were insufficient and further concerns were identified. This continued to put people using the service at unnecessary risk of receiving inappropriate or unsafe care.

The improvements made at the service were mainly in respect of the approach of staff who we found to be more caring and positive towards people than previously. Staff communicated better with people, and there was a positive, inclusive and empowering culture at the service. As a result, people using the service were more relaxed, and those we spoke with praised the services provided.

However, a staff information handover took place with a person using the service present. This compromised the person’s dignity and the privacy of information about other people using the service.

There remained risks to people’s health, safety and welfare as a result of the service’s approach to people’s individual health, safety and nutritional needs and risks. The advice of relevant healthcare professionals such as dietitians was not always promptly sought in response to risks such as significant weight change, and where advice was provided, timely care planning and action did not always take place in response.

People’s individual risk assessments and care plans were not comprehensive or kept up-to-date to reflect people’s current needs. Monthly progress reviews did not consistently monitor and evaluate all goals set up in people’s care plans. This put people at risk of receiving care and support that was not appropriate or did not meet their needs.

There were improvements to medicines management; however, there remained risks to people being supported to receive their medicines safely.

Some fire safety equipment was not properly maintained, and there was a lack of recent fire safety checks, which meant that fire safety risks were not being safely managed.

People’s health, safety and welfare were compromised due to a range of ineffective processes for assessing, monitoring and taking action to address risks and quality shortfalls. Records, particularly for the care and support of people, were not always accurate or complete. There was overall poor governance at the service.

Recruitment procedures had not been operated effectively to ensure that staff members were of good character, because appropriate references were not in place. Systems and processes to prevent abuse of people were not being effectively operated because whistle-blowing procedures were not properly established.

The support, supervision and training of staff was not appropriate to enable them to carry out their care and support duties effectively. Staff lacked sufficient training on meeting the needs of people using the service in respect of nutrition and mental health needs, and they were not receiving regular supervision.

Whilst the service was not unlawfully depriving anyone of their liberty, the provisions of the Mental Capacity Act 2005 were not being followed in full at the service, as people’s capacity to refuse some specific support that might reasonably be seen as in their best interests had not been assessed.

We had not been notified as required of a change of company director and two separate police visits to the service, and we found that the required display of the rating from our previous inspection was not occurring. This undermined our confidence in the management of the service.

We found overall that people using the service continued to be at risk of receiving inappropriate or unsafe care. We found ten breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and two breaches of the Care Quality Commission (Registration) Regulations 2009.

Following this inspection we continued with our enforcement action. The action we took was to serve a notice proposing to cancel the registration of the provider. Due process was followed and we served a Notice of Decision to cancel the provider’s registration which meant that Rainbow Homes London Limited was closed by the Care Quality Commission on 18 December 2015.