20 November 2014
During a routine inspection
The inspection was unannounced and was carried out on 20 November 2014. The previous inspection was carried out 9 April 2013 and there had been no breaches of legal requirements at that time.
College House Care Home provides accommodation and personal care for up to 21 older people. At the time of our inspection there were 18 people living in the home.
A registered manager was in post at the time of inspection. 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 and associated Regulations about how the service is run.
There was also a ‘home manager’ in place that we were told managed the home day to day and lived on the premises. People confirmed they saw this member of staff as the person they would go to on a daily basis as the manager. In this report they will be referred to as the home manager. We were told the registered manager had a presence in the home on a regular basis.
People in the home were not always safe. We found several errors in the recording and auditing of medicines. The procedures for managing people’s medicines were not safe in all areas. This was around accuracy in medicines stock levels, discrepancies in the way ‘as and when required ‘medicines were administered and the lack of a robust auditing process.
Only the manager, registered manager and deputy manager had received training in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. People who lacked capacity had not been assessed and action taken as a result.
The provider had not ensured that staff had the knowledge and skills they needed to carry out their roles effectively to meet the needs of people who used the service. Relevant training was not up to date to ensure staff knowledge was current.
Improvements needed to be made with the risk assessment processes. Some people’s risk assessments lacked detailed professional advice that should be sought to ensure clear guidance for staff to follow to ensure people were kept safe and protected from the risk of harm
Some people’s care files lacked information in relation to their care and treatment. This included nutritional and repositioning recording charts. This posed a risk that people’s individual needs would not be met effectively.
Quality and safety in the home was monitored in some areas to support the registered manager in identifying any issues of concern. People were asked for their opinion on the care they received. However, auditing systems were not robust in respect of medicines, care planning and infection control audits. The provider had not identified the shortfalls we identified during this inspection.
People were happy with the food and drink they received in the home. We observed a mealtime where people’s needs were being met.
People we spoke with were positive and felt well cared for and told us that their needs were met. Positive and caring interactions by staff were viewed during our inspection.
Staff meetings were scheduled regularly and staff were encouraged to express their views. However, not all staff received regular one to one supervision to support then in their role.
Meetings were held with people and their relatives to ensure that they could express their views and opinions about the service they received. People could also raise any complaints at these meetings.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.