This was an unannounced inspection which took place on 24 March 2015 and 7 April 2015. The service was last inspected on 23 September 2013 when we found it to be meeting all the regulations we reviewed.
Walshaw Hall provides accommodation for up to 50 people who have personal care needs, including those with dementia. There were 44 people living in the service on the day of our inspection.
The service had a registered manager in place at the time of our inspection. 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.
During this inspection we found that a staff member failed to recognise that a safeguarding incident had occurred and did not report this to the registered manager.
People were at risk of receiving unsafe care and support as risk assessments were not in place to show how identified risks were to be managed.
Correct recruitment procedures were not followed for volunteers. This meant that people who used the service were not protected against the risk of unsuitable people working within the service.
We found the management of medicines was unsafe and did not protect people who used the service. Care staff members handled medicines with their bare hands, medicines were not stored safely, inaccurate recordings of when medicines had been given and there was no robust system in place to account for controlled drugs.
People who used the service had access to hazardous substances. A clinic room and hairdresser’s room containing sharp objects and hazardous liquids were unlocked.
We found the registered manager had identified a number of people for whom a Deprivation of Liberty Safeguards (DoLS) application was required. However, we found that no applications had been made and consequently people were being deprived of their liberty unlawfully.
People who required support to eat were left for long periods of time with their food in front of them before assistance was given. Those people who were supported to eat their meal were not given sufficient time to swallow their food.
People were not given a choice of what drink or biscuit they would like during the drinks service. Staff chose the biscuit and handed this to people with their bare hands.
We observed one staff member treat people in an undignified and disrespectful manner. A safeguarding alert was raised regarding this concern by the registered manager and the inspector.
Confidential information about a service user’s medication was displayed on a notice board in a thoroughfare.
People were sitting in wheelchairs for long periods of time in the main lounge and library areas. The registered manager and staff members could not tell us why people had not been supported to transfer to a comfortable chair.
There was a lack of stimulation for people with dementia. Sensory equipment was stored in the attic area of the service and not made readily available for people to use.
Care records we looked at did not contain sufficient information to show how people who used the service were to be supported and cared for.
People’s health and welfare was at risk due to the lack of risk assessments for choking, pressure ulcers and bed rails.
There were no robust systems in place to assess and monitor the quality of the service provided to ensure people received safe and appropriate care.
The registered manager lacked knowledge in key areas such as Deprivation of Liberty Safeguards (DoLS).
During this inspection we found the service was clean and people were able to personalise their rooms to their own tastes.
People told us their privacy and dignity was always maintained.
People knew how to make a complaint and told us they felt able to approach the staff with any concerns.
The registered manager had regular meetings for people who used the service where they were able to discuss anything about the service or their care.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.