Background to this inspection
Updated
20 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Inspection team: One adult social care inspector and one expert-by-experience in older adults and dementia care undertook this inspection.
Due to technical problems on our part, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
Service and service type: This is residential home. It provides accommodation and personal care for up to 16 people. It provides a service to older adults who may have physical disability and/or dementia.
Notice of inspection: This was an unannounced inspection.
What we did;
Before inspection:
¿ Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public and local authorities.
During inspection:
¿ We spoke with seven people who used the service and five relatives. We spent time in the communal areas to understand how people spent their day.
¿ We spoke with the four care staff, the cook, the manager and the area manager.
¿ We looked at aspects of three people’s care records medicine records, nutritional information, incidents and accidents, residents and relatives meeting, staff meeting minutes and the complaints procedures.
After inspection:
¿ We spoke with the provider and the area manager.
¿ We spoke with the Local Authority and Safeguarding.
¿ We wrote to the provider for further information about the management arrangements for the service and an action plan to address the identified concerns..
¿ We spoke with the police following an incident at the service which was after our inspection visit.
Updated
20 June 2019
About the service: College House Residential Home is service that provides accommodation and personal care for up to 16 people. At the time of our inspection, 13 older people were living in the home, some of whom may have a physical disability and/or dementia.
College House is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is in one adapted building over two floors.
There was a registered manager at the time of the inspection. However, during our inspection visits, we were told they were not available, and would be de-registering. A new manager was in post who told us they would be applying for registration, however five days after our inspection we were told they were not working at the service.
Rating at last inspection: At the last inspection the service was rated Good. The report was published 25 January 2017.
Why we inspected: This was a scheduled inspection based on the previous rating. However we had also received significant concerns from the Local Authority following their recent quality monitoring visit to the home so brought the inspection forward.
People’s experience of using this service:
¿ People were not always protected from abuse because the provider’s systems and processes to protect them were not in place to identify and respond to all allegations of abuse.
¿ People were exposed to significant risk of harm as their care needs had not been assessed, monitored and reviewed.
¿ There were enough staff on duty to keep people safe and meet their needs.
¿ People’s medicines were not always managed in a safe way.
¿ Infection prevention and control practices were not monitored or reviewed.
¿ People were not supported to have maximum choice and control of their lives and staff did not work within the principles of the Mental Capacity Act (2005)
¿ Staff sought external healthcare professionals’ advice but did not follow their guidance in how to support people.
¿ Staff spoke to people in a kind and caring way
¿ People’s care was not delivered in a timely way, and changes in care were not always clearly communicated to the staff team.
¿ People were not supported to go on outings. People with dementia were not provided with activities that stimulated them.
¿ Record keeping of complaints was poor to enable the provider to demonstrate whether any had been received and acted upon in-line with their policy.
¿ The provider’s quality assurance systems had not always been effective in identifying shortfalls in care and treatment for people. Improvements in quality assurance to assess, monitor, mitigate and improve the service were underway.
We found four breaches of regulation at this inspection: Regulation 11, 12, 17 and 18 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The overall rating for this service is ‘Inadequate’ and the service is therefore 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.
Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.
Enforcement: 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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk