We inspected West Bank Care Home on 24 and 30 March 2016 and the visit was unannounced. Our last full inspection of this service took place in June 2013. At that time, we found the provider was not meeting the regulations in relation to staffing and safe management of medicines. We took enforcement action and made two further visits to check that improvements had been made.
West Bank Care Home is a privately owned care home for adults who are living with a mental illness. The home is registered to carry out the regulated activity accommodation for persons who require nursing or personal care. Nursing is not provided. The home is registered to accommodate a maximum of ten people. There are eight bedrooms, one of which is shared. There is a dining room and lounge on the ground floor and a communal bathroom on the first floor.
At the time of our inspection the person managing the service was not registered with the Care Quality Commission.
A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People who used the service told us they felt safe with the care they were provided with.
We found the home had not been maintained safely and standards of décor, furnishings and cleanliness were poor. For example there were no window restrictors in place, water at several outlets was running at a temperature which could have caused scalding and the call system was not working. Several areas of the home were not clean. We found this was a breach in regulation as the premises were not clean or well maintained.
Systems for managing medicines required some improvement as there were no protocols in place fro medicines prescribed on an 'as required or PRN basis. We found this was a breach in regulation.
Recruitment processes were robust and checks were completed before staff started work to make sure they were safe and suitable to work in the care sector. Staff told us they felt supported by the manager and that training opportunities were good. However we found staff had not received practical training in moving and handling people. We found this was a breach in regulation.
We found staff friendly and helpful and there was a nice atmosphere in the home. People who lived at the home told us they liked the staff.
We found the poor environmental standards demonstrated a lack of respect for the dignity of the people who lived at the home. We found this was a breach in regulation.
There were enough staff on duty to make sure people’s care needs were met and people were able to follow their choices in their daily routines.
We saw little evidence of people being supported in engaging in independent living skills
People had access to healthcare services as they were needed.
We found the service was meeting the legal requirements relating to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).
People who lived at the home and staff spoke positively about the manager who was described as supportive and caring. We found them to be knowledgeable about their role. However, although some quality assurance systems were in place, the systems were not effective as they had failed to identify and rectify the significant issues we found at this inspection. We found this was a breach in regulation as there was not good governance.
Overall, we found significant shortfalls in the service provided to people. We identified three 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.
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.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.