Background to this inspection
Updated
10 March 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.
This inspection took place on 10 December 2014 and was unannounced.
The inspection team consisted of two inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection we looked at the information we held about the service. This included notifications the service had sent us. A notification is information about important events which the provider is required to send us by law. The provider had completed a provider information return (PIR), this is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also received information from two health and social care professionals who support people who use the service.
During the inspection we spoke to 10 people who used the service and one visitor. We spoke to eight care staff, the acting manager and regional manager. We pathway tracked two people. Pathway tracking helps us understand the outcomes and experiences of selected people and the information we gather helps us to make a judgement about whether the service is meeting the essential standards of quality and safety. We looked at the care records for a further six people and saw staff rosters, the training records, evidence of staff support and supervisions, three staff recruitment files and quality monitoring audits the provider had in place.
Updated
10 March 2015
This inspection took place on the 10 December 2014 and was unannounced.
At our previous inspection in June 2014 we found the provider did not keep protect people from the risks associated with the unsafe management of medicines. People’s care and welfare needs were not always met. The provider’s quality monitoring systems were not effective and staff were not supported to fulfil their roles. Due to the seriousness of the issues relating to the safe management of medicines we issued the provider with a warning notice. We conducted a follow up inspection in August 2014 to look to see if improvements had been made in this area and found that although some improvement had been made the provider was still not managing people’s medicines safely.
Sister Dora provides accommodation and nursing or personal care for up to 47 people. At the time of the inspection 34 people were using the service.
The home has a registered manager although they had been absent from the service since May 2014 and the deputy manager was acting as the manager in the interim. 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.
At this inspection we found that the provider continued to not ensure that people’s medicines were managed safely. Medicine were not administered safely and people were at risk of receiving medicines that were out of date.
The provider was not following the principles of the Mental Capacity Act 2005 and The Deprivation of Liberty Safeguards. The Deprivation of Liberty Safeguards are for people who cannot make a decision about the way they are being treated or cared for in a hospital or care home, where other people are having to make this decision for them. Not all people had not been involved in the decision making about their own care, treatment and support. We raised a safeguarding referral with the local authority for one person who may have been restricted of their liberty.
People told us and we saw that people who used the service were treated with dignity and respect and their privacy was ensured at all times. Activities were on offer dependent on people’s individual preferences.
Staffing levels were sufficient to meet the needs of people who used the service. People did not have to wait to have their care needs met.
Staff had received a period of induction and training to become competent in their role.
People received health and social care support when they needed it. When people’s needs changed or they became unwell the relevant professional advice was gained in a timely manner.
People who used the service and their relatives were kept informed and involved in the running of the home. There was a complaints procedure and we saw that formal complaints had been managed appropriately.