Archived: Minster Rest Home

Updated 27 July 2016

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.

This inspection took place on 14, 15 April 2016 and 9 May and was unannounced.

We reviewed the information we held about the service. We looked at information received about the home and the statutory notifications the manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law. We spoke with Coventry local authority commissioners who funded the care for some people at the home. They told us they had identified some areas for improvement and they were working with the home in relation to these. Following our inspection visits, we informed the local authority commissioners about concerns we had identified related to the safety and quality of care that people received.

The inspection was carried out by three inspectors over a three day period. We spoke with seven people who lived at the home, three visitors and five care staff. We also spoke with both owners of the home, one of whom was also the registered manager of the service. When referring to the provider in this report this includes the registered manager.

We observed the staff interactions with people and the support they delivered in the lounge and dining area. We also visited people in their rooms where staff also provided support.

We reviewed the care plans of three people and viewed some of the records in the files of others to see how their support was planned and delivered. We also looked at other records such as medication records, accident and incident records, recruitment files, complaints records and health and safety records.

Updated 27 July 2016

We carried out an inspection of Minster Rest Home on 14 and 15 April and 9 May 2016. The inspection was unannounced.

Minster Rest Home provides personal care and accommodation for up to 19 older people. Some people had mental health conditions. There were 17 people living at the home when we carried out our inspection on 14 and 15 April and 18 people on 9 May 2016.

A requirement of the service’s registration is that they have a registered manager. 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. A registered manager, who was also one of the providers, was in post.

People we spoke with had mixed views about whether they felt safe at the home. We found risks associated with people’s care, as well as health and safety risks related to the premises, were not always identified and assessed to make sure people were protected from the risk of harm. We spoke with the local authority about concerns we had identified. A visit by the local authority and other health professionals resulted in one person being relocated to alternative accommodation.

There were insufficient numbers of staff to meet people's needs safely and effectively. Care staff were required to complete additional duties such as cleaning and cooking which prevented them from focusing on meeting people’s needs. People told us they felt some of their needs were met but said staff were always rushed and had little time to spend with them. People had limited opportunities to engage with staff and build relationships with them so they felt valued as a person.

Some pre recruitment checks were completed on new staff , but it was not always clear the provider had checked their suitability to work with people in the home. Staff training was not up-to-date and we observed staff did not always support people in a safe way.

People received their medicines but records were not sufficiently detailed to confirm these were always given as prescribed.

People were not routinely provided with a choice of meals and people told us they wanted more choices to be offered. Meals, snacks and drinks were provided at set times during the day as opposed to as and when people wanted them. Where required, people were supported to eat although this was not always a positive experience for them. People had access to healthcare support when needed.

The principles of the Mental Capacity Act were not understood or routinely followed by staff. There were people in the home who were subject to restrictions related to their care. It was not clear whether these people had capacity to make their own decisions or whether decisions about restrictions applied to their care had been agreed with them or were made in their best interests.

The provider had not ensured the rooms people occupied were safe and comfortable. We found many of the rooms had broken items of furniture and some of the taps did not work effectively. Some people had portable heaters in their rooms either due to heating problems or because they felt cold. The heaters had not been risk assessed to ensure they were safe to use.

The home was not consistently responsive to people's needs. People's choices and preferences were not regularly sought and people felt they were not listened to. People had limited stimulation and opportunities for their social needs to be met. A lack of background information about people’s interests and preferences meant there were people who did not experience person centred care.

There was a complaints procedure and a system to record complaints. Relatives told us they felt confident to raise any complaints with the registered manager if needed. However, we could not be confident that complaints received were always recorded to demonstrate the provider had taken them seriously and had addressed them.

The provider did not have sufficient systems and processes in place to assure themselves that people living at the home received a good quality service that met their needs. People were not given opportunities to provide their opinions of the service and to be regularly involved in decisions related to their care. There was a lack of audit processes to ensure improvements to the service were identified and acted upon in a timely manner, for the benefit of people who lived there.

We found a number of 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 will therefore be placed 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.