Archived: New Beginnings Residential Care - 63 Kingsley Road

Updated 5 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was 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 22 and 23 February 2018. The inspection on 22 February 2018 was unannounced, but the inspection on the second day of the inspection was announced.

The inspection visit was carried out by one inspector.

Before the inspection visit we looked at all the information we held about the service. This included notifications of significant events and the last inspection report.

We met and spoke with two people who lived at the home. Whilst they were able to communicate with us, this was limited. We therefore observed how they were cared for and supported by care staff. On the first day of our inspection, the operations manager was not present for most of the day. We spoke with two care staff on the day and briefly to the operations manager. On the second day of the inspection we spoke with the operations manager. Following the inspection, we spoke with another care staff.

During the visit we looked at the care plans and records for two people, staff recruitment and training records for three members of staff. We also looked at records of complaints, accidents, incidents and other records the provider used for monitoring and managing the service. We looked at the environment and how medicines were managed and stored.

Updated 5 April 2018

This inspection took place on 22 and 23 February 2018 and was unannounced. New Beginnings Residential Care - 63 Kingsley Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission [CQC] regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were two people who had learning disabilities living in the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Our previous inspection on 2 February 2017 found four breaches of regulation and made one recommendation. We rated the home as “requires improvement”. During this inspection on 22 and 23 February 2018, we found that the home had made some improvements. However, we found that that there was not a clear management structure in place and that there were concerns in relation to staffing arrangements.

There was no registered manager in post at the time of this 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 and associated Regulations about how the service is run.

Our previous inspection found that there were some aspects of the care provided that were not safe. We previously found that fire safety arrangements were not adequate and we found a breach of regulation in respect of this. During this inspection in February 2018, we noted that the home had taken action in respect of this and had implemented fire safety checks and staff had received fire safety training.

Our previous inspection also found that medicines were not stored appropriately and we found a breach of regulation in respect of this. During this inspection, we noted that the home had made improvements in respect of this. We however, noted that the home had failed to document one person’s PRN medication appropriately and we have made a recommendation in respect of this.

We looked at the staffing rota and noted that it did not accurately reflect the staffing arrangements in the home. For example; the rota stated that the operations manager would be working from 9am to 5pm on both days of the inspection. However, this was not accurate as the operations manager was only present for a short period of time on both days. Further, the rota did not correctly detail which care staff were working on both days. We were therefore not satisfied that staff were always deployed as required to meet people’s needs and we found a breach of regulation in respect of this.

Risk assessments had been carried out which detailed potential risks to people and how to protect people from harm.

The home had carried out some checks on staff suitability to work with vulnerable people. They had carried out checks on their criminal records and their identity and eligibility to work in the United Kingdom. However, there was a lack of evidence to confirm that references were obtained and we found a breach of regulation in relation to this.

Our previous inspection found that people’s care plans lacked information about what support people required. We previously found a breach of regulation in respect of this. During this inspection, we noted that the home had made improvements in this area. They had implemented a new format support plan for people which included information about what support people required as well as how they wished to be supported with various aspects of their daily life.

Our previous inspection found that there were significant gaps in staff training and a lack of appraisals and we found a breach of regulation about this. During this inspection, we noted that the home had made improvements in respect of this and staff had completed necessary training and where required they had received an appraisal.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Our previous inspection in February 2017 found that there was a lack of information about people’s mental capacity and communication in people’s care records. During this inspection in February 2018, we found that information about people’s communication and their capacity to make decisions was documented in care support plans.

The arrangements for the provision of meals were satisfactory. We saw that there was a weekly menu. Staff confirmed that they asked people what they wanted to eat and then prepared meals based on this. We looked at the menu for the week of the inspection and noted that there was a variety of meals available. On the first day of the inspection we observed both people in the home prepare their lunch with the support of a member of staff.

We observed interaction between staff and people living in the home during our visit and saw that people were relaxed with staff and confident to approach them. Staff interacted with people, showing them patience and respect.

Our previous inspection recommended that the provider reviewed the provision of activities at the home to ensure people are provided with mentally stimulating activities. We previously found that there were a lack of activities available to people. During our inspection in February 2018, we noted that the home had made improvements in respect of this. The operations manager confirmed that since the inspection, they had arranged for both people to attend a day centre three times a week. We also saw evidence that each person had their own activities timetable which was documented in their support plan based on their individual interests.

Our previous inspection found that there was a lack of evidence to confirm that regular audits were carried out in respect of various aspects of the care provided and we found a breach of regulation in respect of this. During this inspection, we found that the home had undertaken checks and audits of the quality of the service in areas such as health and safety, fire procedures, medicines management and care documentation.

During both days of the inspection we found that there was a lack of management presence and we were not confident that there was a suitable management structure in place in the home.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.