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Archived: Blakenhall Resource Centre Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 16 March 2015

At our previous inspection on 1 April 2014 the provider was not meeting the law in relation to the care and welfare of people using the services, the management of medicines and the assessing and monitoring of the quality of service provision. Following this inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made.

This inspection took place on 22 and 24 October 2014 and was an unannounced inspection.

Blakenhall Resource Centre provides long term and short term accommodation and care for up to 29 older people who have mental health needs. There were four people living at the home on a long term basis and four people living at the home on a short term basis when we inspected.

The service had a registered manager, as required by the terms of its registration. 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. At the time of our visit the registered manager was on a long term absence and the service was being managed by a temporary care manager since September 2014.

People and their relatives gave mixed views about their experiences of the service. Some relatives and people told us they were happy with the service. However, other relatives raised issues with us. This included one view that a person’s health and well-being had deteriorated since their time at the service and that this was due to poor care. Other relatives told us they felt poor morale among staff was affecting the standard of care. While we observed some improvements since our last visit on 1 April 2014, we identified a number of concerns with the service.

We found that inadequate responses had been made to an incident involving a person falling. This included a failure to ensure their environment was safe and that staff had updated guidance on how to support them safely. We saw that risk assessments were not consistently updated to reflect the current risk to people’s safety and well-being.

We found some improvement in the completion of people’s medication administration records. However, we found further concerns around the administration of ‘when required’ medicines, the storage of medicines and the records maintained for people. Controlled drugs were appropriately stored and recorded.

We found there were adequate staff available to support people.

Staff knew how to identify abuse and to report it. However, we were aware of safeguarding matters that should have been reported to the local safeguarding authority, but were delayed.

Staff had poor knowledge of Deprivation of Liberty Safeguards (DoLS) and gave inconsistent answers about people who were subject to a DoLS. This meant there was a risk that people’s rights would not be appropriately supported.

We found that there had been improvements in the provision, monitoring and recording of fluids given to people to drink. People’s cultural preferences around food were respected.

We found that there were gaps in some areas of staff knowledge and training. Issues of performance had not always been addressed with staff by the management team.

We found staff assisted people in a caring and compassionate way. However, we observed that staff missed opportunities to interact with people more frequently in order to improve their experience of the service.

Not all relatives felt that staff listened to them when they explained the needs of people living at the home.

The personalisation of care plans had improved since our last visit. However, some care plans contained contradictory information about people’s needs.

We saw some activities being provided to some people which met people’s interests. However, we also saw examples of people not receiving stimulation during our inspection.

Visitors to the service told us they were welcomed by staff, which meant that people were able to maintain relationships which were important to them.

The provider had a robust complaints procedure. People had access to information about how to make a complaint.

We found a number of issues which the provider’s own audits had failed to identify. We found examples of the provider not implementing the action plan they had submitted to us following our last visit. We also found that the provider had not implemented advice given by the local Clinical Commissioning Group (CCG) who buy and monitor health and social care services.

The provider had failed to notify us of issues which it was required to do so by law. The provider had also failed to send us information it we had requested within a specific timescale. The information requested was a ‘Provider Information Return’ in which the provider is asked to describe how they are meeting current legislation in the provision of care.

We found that the provider had not fully met the action plan they had sent to us. We also found a number of additional issues during this visit. We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Inadequate

Updated 16 March 2015

The service was not always safe.

There was inconsistent knowledge from staff about how to reduce risk to people. This meant that people did not always receive care in line with how risks to them had been assessed.

Medications were not safely managed and monitored so that people received their medication in a safe way which supported their health and well-being.

People were supported by safe levels of staff. Staff knew how to identify and report abuse.

Effective

Requires improvement

Updated 16 March 2015

The service was not always effective.

Staff had inconsistent knowledge about people’s rights, such as who was subject to certain restrictions and who was not.

There were some gaps in staff training and staff performance was not always addressed effectively.

People’s health was supported by adequate nutrition and hydration.

People were supported to attend appointments with external healthcare professionals, which supported people’s health.

Caring

Requires improvement

Updated 16 March 2015

The service was not always caring.

Relatives did not always feel listened to by staff about their opinions on the care people received.

Interactions between staff and people were caring, but limited in frequency. Opportunities for positive interactions were sometimes missed by staff.

Staff delivered care while respecting people’s dignity and privacy.

Responsive

Requires improvement

Updated 16 March 2015

The service was not always responsive.

Care plans did not always provide consistent information about people’s needs. This meant that staff did not have consistent guidance in records about people’s needs.

Some aspects of care planning were not appropriately updated following incidents.

Some people participated in activities, but others received little stimulation throughout the day.

The provider had a robust complaints procedure. People had access to information about how to make a complaint.

Well-led

Inadequate

Updated 16 March 2015

The service was not well-led

We found that the provider had not fully implemented the action plan they had sent us to improve on shortfalls we had found at our previous inspection. This meant there continued to be issues around the quality and safety of the service.

We found a number of concerns during our inspection which the provider’s own audits had failed to identify. This meant that issues which could affect people’s experience of the service were not being routinely identified and addressed.

The provider had failed to notify us of matters which they are required to do so by law, such as a person sustaining a serious injury.