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We are carrying out a review of quality at Scarletts. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 26 June 2018

This was an unannounced and focused inspection of Scarletts residential home carried out on 19 and 21 March 2018.

Scarletts is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and we looked at both during this inspection.

Scarletts accommodates and provides personal care for up to 50 older people. At the time of this inspection, there were 18 people accommodated, who were vulnerable due to their age and frailty, and in some cases had specific and complex needs, including varying levels of dementia related needs and end of life.

The service had no registered manager in post. However, a new manager who intended to apply for registration had started work at the service on the day of our 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 2008 and associated Regulations about how the service is run.

We carried out an unannounced comprehensive inspection of Scarletts in June 2017 and we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was poor leadership, management and provider oversight of the service resulting in people receiving poor care and risks to people’s health and welfare not being adequately protected. We took immediate enforcement action to restrict admissions and placed conditions on the provider’s registration to improve the assessment of risk, leadership, staffing and oversight.

The service was given an overall judgement rating of ‘inadequate’ and is therefore in special measures.

We continued to keep Scarletts under review and following information from whistle-blowers and the local authority, we carried out unannounced, focused inspections in September 2017 and December 2017 and met with the provider’s representatives in January 2018. These inspections focused on the areas of ‘Safe’ and ‘Well led’. We also checked the provider’s progress in addressing the breaches of Regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 identified at our comprehensive inspection in June 2017.

We found continued and widespread concerns with the governance, leadership and provider oversight of the service resulting in a failure to address recurring areas of risk to people and to learn lessons when things had gone wrong. There was a failure to drive and sustain improvement.

The local authority safeguarding and quality monitoring teams continued to monitor the service through regular visits and support, mitigating the risk to people using the service.

You can read the reports from our previous inspections, by selecting the 'all reports' link for Scarletts on our website at www.cqc.org.uk

This inspection focused on the areas of ‘Safe’ and ‘Well-led’. We found that sufficient improvement had not been made since our last inspection and the provider was continuing to fail to meet the requirements of the regulations, commonly referred to as The Fundamental Standards of Quality and Safety.

Risk management processes continue to be ineffective and the provider continued to demonstrate a lack of understanding of the risks affecting people living at Scarletts. Staff were not equipped with the right information and skills so that people receive safe and appropriate care. People were not protected from the unsafe management of medicines.

Robust and sustainable auditing and monitoring systems were not in place to ensure that the quality and safety of care was consistently assessed, monitored and improved. Failures in the service continued to be widespread and demonstrated the provider's inability to make and sustain improvements. We continue to have concerns abo

Inspection areas

Safe

Inadequate

Updated 26 June 2018

The service was not safe.

Risks to individuals in relation to choking had not been assessed.

Staff did not support people in the least restrictive way possible.

Environmental risks were not effectively identified or managed and the cleanliness of the service needed improvement.

Staffing levels required review to ensure they met the needs of those living at the service.

Effective

Inadequate

Updated 13 October 2017

The service was not effective.

Training and development was not sufficient in some areas to assist staff in the delivery of safe and effective care.

People were not always supported effectively with their nutritional needs.

People were not always supported in line with the Mental Capacity Act.

Caring

Inadequate

Updated 13 October 2017

The service was not caring.

The provider had not ensured the service was being run in a manner that promoted a caring and respectful culture.

Although some staff were attentive and caring in their interactions with people, they were not supporting people in a consistent and planned way.

Responsive

Inadequate

Updated 13 October 2017

The service was not responsive.

Care plans were task focused and not personalised or centred on individual’s needs, wishes choices and preferences.

There was a lack of general activity throughout the day to ensure people’s whole well-being.

It was unclear how the results of people’s feedback were used to drive forward improvements which were embedded and sustained.

Well-led

Inadequate

Updated 26 June 2018

The service was not well-led.

Robust audit and monitoring systems were not in place to ensure that the quality and safety of care was consistently assessed, monitored and improved.

There was a failure to recognise and effectively act on failings which impacted on the quality of service provision.

There had been a lack of oversight of the service by the registered manager and provider to ensure the service delivered was safe and that they kept up to date with best practice.