Archived: Raycroft Unit

Updated 7 September 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was unannounced and took place on 24 February and 03 March 2015. The inspection team consisted of an adult social care inspector and a bank inspector.

We reviewed information we held about the home, such as statutory notifications, safeguarding information and any comments and concerns. This guided us to what areas we would focus on as part of our inspection.

We spoke with a range of people about the service. They included eight people who lived at the home, two visiting family members, a visiting health professional and three staff members. We also spoke with a director of the company that operated the service. In addition we spoke to the contracts and commissioning department and safeguarding team at the local authority. This helped us to gain a balanced overview of what people experienced when living at this home.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We also spent time looking at records, which included three people’s support records, training and recruitment records for three members of staff and records relating to the management of the home.

Updated 7 September 2015

The inspection was unannounced and took place on 24 February and 03 March 2015.

The previous full inspection at the Raycroft Unit was carried out on 12 February 2013. The service was judged to be non-compliant in three outcomes, infection control, supporting workers and quality assurance. The home was re-visited on 12 June 2013 and the provider had made the necessary improvements to meet the relevant requirements, however was judged to be non-complaint for not having an effective complaints procedure in place. We revisited the home on 05 February 2014 and the provider had made the necessary improvements to meet the relevant requirements.

The Raycroft Unit is registered to provide care for up to 11 older people who do not require nursing care. It is situated in a residential area of Morecambe. At the time of our visit there were 11 people who lived there. Accommodation is on two floors with a stair lift for access between the floors. All rooms are ensuite. The home is situated close to shops, buses and the local facilities of Morecambe.

There was a registered manager in post. 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.

During the inspection the registered manager was not present. We spoke with the care manager and a director of the company that operated the service.

We spent time in all areas of the home, including the lounge and the dining areas. This helped us to observe daily routines and gain an insight into how people's care and support was managed. During our visit we saw staff had developed a good relationship with the people they supported. Those people who were able to talk with us spoke positively about the service and told us they felt well cared for. One person told us, “The staff are all very nice. I can’t say anything about them.”

Through our observation and discussions with people we noted that a number of systems to monitor the quality of the service and keep people safe had failed. There were numerous breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This meant the service was not safe, effective, caring, responsive or well-led. You can see what action we told the provider to take, can be seen at the back of the full version of the report.

Staff spoken with understood the procedures in place to safeguard vulnerable people from abuse. However risks to one person were not being managed appropriately to keep them safe. We also observed that one person’s liberty was deprived without the authorisation of the appropriate supervisory body. You can see what action we told the provider to take at the back of the full version of the report.

The staffing levels at night were inadequate to keep people safe. There was only one member of staff on duty at night time. Staffing levels were not assessed and monitored to make sure there were sufficient staff on duty to meet people’s individual needs and to keep them safe. You can see what action we told the provider to take at the back of the full version of the report.

The registered manager and provider had not taken steps to ensure contractors had undertaken electrical safety tests within the industry recommended timescale. There were shortcomings in the fire safety arrangements. In addition there had been no maintenance work undertaken to secure the building. Suitable arrangements were not in place to manage the risks to the health, safety and welfare of people who lived at the home. You can see what action we told the provider to take at the back of the full version of the report.

We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration. Records we checked were complete and accurate and medicines could be accounted for because their receipt, administration and disposal were recorded accurately.

The provider had failed to implement thorough recruitment practices to ensure that staff employed to work at the home were suitable for their role. You can see what actions we asked the provider to take at the back of the full version of the report.

Staff had not completed infection control training and improvements were required to the environment to minimise the risk of cross infection for people who lived at the home, staff and visitors. You can see what action we told the provider to take at the back of the full version of the report.

Suitable arrangements were not in place to ensure staff received appropriate training to carry out their role and responsibilities. Training requirements for staff members had been identified but not delivered. You can see what action we told the provider to take at the back of the full version of the report.

People were involved and consulted with about their needs and wishes. Care records provided information to direct staff in the safe delivery of people’s care and support. However records needed to be kept under review so information reflected the current and changing needs of people.

Staff had a good understanding of people’s daily care needs and where necessary, ensured that people who used the service had access to community health care and support. Community professionals reported positive relationships with the service and felt staff were professional and cooperative.

Calderdean Limited are registered with the Care Quality Commission to provide a service at two locations. Raycroft Unit and Alders Residential Home. In August 2014 the registered manager for Raycroft had taken on the extra responsibility of managing the Alders and had based himself at the Alders Residential Home from August 2014. There was no clear leadership at the Raycroft Unit. The systems to monitor the quality of the service and keep people safe had failed. You can see what action we told the provider to take at the back of the full version of the report.

It is a requirement of the Care Quality Commission (Registration) Regulations 2009, that the provider must notify the Commission without delay of the death of a person who lived at the home. In addition the provider should notify the Commission of other incidents including the serious injury to a person. This is so that we can monitor services effectively and carry out our regulatory responsibilities. We noted during our inspection that deaths and incidents which had resulted in a person receiving treatment at hospital should have been notified to CQC. The registered manager or provider should have submitted these. Our systems showed that we had not received any notifications. You can see what action we told the provider to take at the back of the full version of the report.