31 January 2017
During a routine inspection
There was a registered manager in place who was also one of two providers whose legal entity was a partnership. 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.
Prior to this inspection concerns were raised to us about people's safety. We found the provider had not responding appropriate to an allegation of abuse. People were not protected from the risk of harm due to the lack of timely medical intervention and people were placed at risk due to unsafe moving and handling practices by staff.
People received their medicines on time and medicines were stored safely. However, the provider did not follow the least restrictive action when administering medicines.
There was a lack of activities and meaningful occupation and there was no documentary evidence that the activities which did take place were planned and evaluated for their effectiveness.
We saw some positive interactions between staff and people however there were some staff practices which demonstrated a lack of empathy.
People had a care plan in place however we found they were not involved in the review of their care plan. Care plans and other documents were not being updated in order to ensure current information was accessible, particularly when providing guidance to staff.
The provider had failed to notify the Commission when required to do so, in relation to a change in their legal entity and notifications in regarding incidents.
Staff training had fallen behind as had staff supervision. Staff had received an annual appraisal.
The provider was not adhering to the principals of the Mental Capacity Act 2005 and we found that people were not involved in the decision making process.
The provider had a system in place for auditing the quality and standard of the service they provided, however these had not been completed to highlight potential shortfalls in the delivery of the service. People and families were not involved in how the service was run and were not asked for their opinion about this.
Staff reported they felt well supported by the provider and were able to approach them if they had any concerns.
Following the inspection, the provider notified us they were closing the service and submitted the relevant notifications to the commission as required.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.