18 August 2022
During an inspection looking at part of the service
Deer Park Care Centre is a residential care home providing accommodation and personal care to up to 38 people. The service provides support to older people with mental health support needs. Some people also had a learning disability. At the time of our inspection there were 31 people using the service. Care was provided to people in one two story building. There was a lift and accessible garden for people. People also had access to kitchen and laundry facilities where they were able to access these independently.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support:
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
There were mechanisms for people to feedback their views on the service. People’s views were listened to and action was taken as a result. Staff felt supported in their role.
Right Care:
People’s care, treatment and support plans didn’t always reflect their range of needs. Some risk assessments were not in place prior to the inspection. However, the service had enough appropriately skilled staff who knew how to meet people’s needs and keep them safe.
Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People were protected from the risk of infection by infection control procedures.
Right Culture:
Quality checks at the service continued to need improvement. Checks had failed to identify concerns such as care plans which required updating. Some checks had not identified actions were needed, such as supporting people to access dental care. Recruitment processes had not always followed safe practices.
Incidents were reported and action taken to minimise risks to people. However, the analysis of some incidents needed to be improved to reduce the risk of re-occurrence. CQC had not always been notified of reportable incidents.
The management of environmental risks had improved since the last inspection.
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 requires improvement (published 09 August 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last eight consecutive rated inspections.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
The inspection was prompted in part by a notification of a specific incident. Following which a person using the service died. This incident is subject to ongoing investigation. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk to people’s health and well-being. This inspection examined those risks. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.
We looked at infection prevention and control 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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report. The overall rating for the service has remained requires improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Deer Park Care Centre on our website at www.cqc.org.uk.
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 monitor the service and will take further action if needed.
We have identified breaches in relation to good governance and failure to notify CQC of a serious injury at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.