Background to this inspection
Updated
11 February 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection site visit was carried out by an inspector and an assistant inspector.
Service and service type
Bethany House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The provider was also registered with the Care Quality Commission as the registered manager. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 17 December 2020 and ended on 15 January 2021. We visited the service on 17 December 2020.
What we did before the inspection
We reviewed information we had received about the service, since the last inspection. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection-
We spoke with four people who used the service and two relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, senior care workers and care workers.
We reviewed a range of documents and records including the care records for five people and multiple medication records. We also looked at a variety of records relating to the management of the service, including policies and procedures.
After the inspection –
We continued to seek clarification from the provider to validate evidence found. We looked at training information, care plans, risk assessments, kitchen management records, medication management records and quality assurance information.
Updated
11 February 2022
About the service
Bethany House is a residential care home providing personal care and accommodation for up to 30 people. The service was supporting eight people at the time of the inspection.
People’s experience of using this service and what we found
People were not supported in a safe way or protected from potential harm. Infection prevention and control (IPC) practices, medicines management and staff recruitment were not safe. Risks to people were not assessed or mitigated.
The providers systems failed to identify that care and support was not provided in a safe way. Check list audits did not identify shortfalls in IPC, medication services, staff recruitment or assessment and mitigation of risk.
The provider took immediate action to protect people from harm, when information of concern was shared with them.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Inadequate (published 31 March 2021) and there were breaches of regulation. At this inspection enough improvement had not been made or sustained, and the provider was still in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at IPC measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches at this inspection in relation to, safe care and treatment, staffing and recruitment, staff training and skills, dignity and respect, and good governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
You can read the report from our last focused inspection, by selecting the ‘all reports’ link for Bethany House on our website at www.cqc.org.uk.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of 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.