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Archived: JD Zencare

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Inspection report

Date of Inspection: 2 June 2014
Date of Publication: 5 July 2014
Inspection Report published 05 July 2014 PDF

Overview

Inspection carried out on 2 June 2014

During a routine inspection

We recently undertook an inspection visit to JD Zencare. We were unable to speak with the majority of people using the service because they had limited verbal communication skills. We observed people using the service and how staff supported and interacted with them. We reviewed four people’s care records. We spoke with six staff. We also reviewed the records in relation to staffing, training and the management of the service. We reviewed the information we had received before and after our inspection visit and considered all the evidence we had gathered under the outcomes we inspected.

Is the service safe?

The majority of people who used the service had limited verbal communication skills, which meant they were reliant on staff to ensure their needs were met safely. We saw staff safely helped people with their daily needs.

Staff we spoke with showed a good understanding of each person’s needs and how they wished to be supported. Care plans and risk assessments were in place, which provided staff the guidance to help keep people safe. However, those care plans used were completed by the previously registered providers and not JD Zencare. That meant that people received care and treatment which had not been properly assessed and may not be delivered in line with their own plan of care.

We, the Care Quality Commission, monitor the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. Proper policies and procedures were in place and the deputy manager understood their responsibilities with regards to promoting people’s human rights and their liberty. This meant that people could be confident that their best interests would be represented and that their wellbeing would be met reliably.

Staff helped people to stay safe as possible. At times this was difficult because the home’s own assessment of the staff required each day was not consistently maintained. The home used agency nurses and care staff to make up the required numbers of suitably qualified and trained staff to meet people’s needs safely. Agency staff were not always fully aware of people’s needs, which meant that they were reliant on the permanent staff to guide them to ensure people’s needs could be met safely.

We found the home did not manage the staffing levels effectively. We reviewed the staff rotas for May and June 2014 and found that agency staff were used most days to make up the numbers of qualified nurses and care staff required. Although the provider used agency staff at short notice, it meant people’s health, safety and wellbeing was put at risk.

Is the service effective?

People were supported with their daily care needs. People went out with staff who were employed to support people to use community amenities to promote their wellbeing. Throughout our inspection visit we saw people remained in the lounge with the television on and the music playing. It was difficult for people to enjoy the entertainment because neither the television nor music could be heard clearly.

We found people did not always experience a good quality of daily life. Staff only interacted with people to provide the care and treatment they needed. Staff had little or no time to do meaningful activities with people.

Records we looked at showed the people’s care needs were reviewed regularly even though the care plans and risk assessments used were completed by the previously registered providers. Records showed that people had access to health care professionals such as the doctor or the dietician. Staff monitored people’s wellbeing and were aware of the actions to take if a person becomes unwell.

People were provided a choice of nutritious meals and drinks that suited their dietary needs and preferences. All the meals were prepared by the trained kitchen staff who took account of people’s preferences to make sure suitable meals were prepared. We observed staff supported some people to eat their meals in a sensitive manner; offering encouragement and conversation that made the meal time experience enjoyable.

Is the service caring?

Throughout our inspection visit we saw staff were caring and treated people with respect. Staff had a good understanding of people’s needs, preferences and interests. Staff were vigilant and showed genuine care for the people who used the service.

The provider had not assured themselves that people’s needs could be met safely because staff referred to the assessed needs and care plans carried out by the previously registered providers. Although staff understood each person’s health and care needs there was a potential risk that any new needs may not be met reliably.

Is this service responsive?

We saw staff responded promptly to meet people’s needs and protect them for any risks or harm. For instance staff acted quickly when they saw a person became unwell and without panicking. Although the person was supported safely, the delay in locating the care plan and the agency nurse’s lack of knowledge about the individual that meant there was a potential risk to that person’s health.

Staff were experienced and previously trained to support people safely. They were aware of the signs that would indicate someone may be unhappy or had a concern. It was clear from our observations that staff understood their responsibility and how to protect people from any unforeseeable harm or risks.

Is this service well led?

We found that improvements were needed to the management of JD Zencare. Although the provider had a system to assess and monitor the quality of service provided, it was not used. The home’s registered manager resigned and the home is currently managed by the deputy manager with support from the provider until a suitably qualified manager can be recruited.

We found that checks were not carried out ensure people’s health, safety and wellbeing was protected. The provider’s own assessment of the required numbers of qualified nurses and care staff was not consistently maintained. People’s care plans and other documentation used and referred to by staff related to those used by the previously registered providers. That meant that the provider had not taken steps to assure themselves that people’s needs were assessed and that care and treatment that was delivered was appropriate. That meant people who used the service were not protected because the service was not well led.