29 & 30 July 2015
During a routine inspection
The inspection was carried out on 29 and 30 July 2015. The first day of the inspection was unannounced.
Beach House is a large terraced house situated on the outskirts of Burnley. The property is in keeping with the neighbourhood and is homely and domestic in style. There is a lounge, a lounge/dining room, house bathroom, kitchen and laundry room. The home can accommodate up to six people with a learning disability in four single and one double bedroom. Some of the bedrooms have en-suite facilities. There is a small garden forecourt to the front of the property. On street parking is available nearby. At the time of the inspection there were three people accommodated at the service, however one person was in hospital.
The service was managed by a registered manager. 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. The registered manager at Beach House is also registered as a provider of the service in a partnership arrangement.
At the previous inspection on 8 May 2014 we found the service provider was meeting the legal requirements.
During this inspection we found there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found there were not enough staff available at the service to make sure people received safe and effective care. Staff recruitment practices had not been properly carried out for the well-being and safety of people who used the service. People’s medicines were not always managed appropriately, which meant there were risks they may not receive safe support. We found proper attention had not been given to supporting people to develop independence skills and making plans to work towards their goals.
The MCA 2005 (Mental Capacity Act 2005) and the DoLS (Deprivation of Liberty Safeguards) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. We found appropriate action had not been taken to apply for DoLS and authorisation by local authorities, in accordance with the MCA code of practice and people’s best interests.
You can see what action we told the provider to take at the back of the full version of this report.
We have made a recommendation about arranging appropriate staff training on the MCA code of practice and DoLS.
We found improvements were needed with the management and leadership arrangements at Beach House. The registered manager was not spending enough time at the service, to provide effective leadership and direction.
Staff spoken with expressed an understanding of safeguarding and protection matters. They knew what to do if they had any concerns. They had received some training on safeguarding vulnerable adults. However we found further progress was needed with safeguarding procedures. At the time of the inspection the local authority safeguarding team were investigating alerts which had been raised with them.
There were some processes in place to maintain a safe, clean environment for people who used the service, staff and visitors. We noted some improvements had been made, including the redecoration of the lounge and the provision of some new furnishings. We found some matters were in need of further attention however, the registered manager was introducing improvements.
Processes were in place to support people with their healthcare needs, by monitoring their wellbeing and keeping appointments with GPs, dentists and opticians.
People made positive comments about the choice of meals provided at the service. However, we found some improvements were needed. Therefore we have made a recommendation about effectively supporting people with their nutritional needs.
We looked at how the service trained and supported their staff. Records and discussion showed a programme of on-line training had recently commenced. Arrangements were in place for new staff to complete initial ‘in house’ induction training. Staff had regular one to one supervision meetings with the registered manager.
People who used the service told us they liked the staff team, they said, “The staff are alright” and “They are good staff.” We saw staff interacting with people in a kind and supportive way. We found people had privacy in their rooms. However we were made aware of a situation which had resulted in a lack of dignity. We have therefore made a recommendation about promoting confidentiality, dignity and respect.
People spoken with had an awareness of the complaints procedure and processes. They were confident that their complaints would be listened to and dealt with. However we had been made aware of some concerns being raised which we found had not been properly investigated, recorded and managed using the complaints procedures.
We found positive relationships were encouraged and supported. People told us of the contact they had with families and friends. They also had some opportunities to take part in some activities.
There were some systems in place for monitoring and checking the quality of the service. It was apparent they were lacking in effectiveness, however, we found further processes were being introduced.
Following the inspection the service provider made the decision to close the home and an application to de-register was submitted to the Commission.