The Care Quality Commission
  • Care Home
  • Care home

Archived: Column Care (North West) Limited

Overall: Inadequate read more about inspection ratings

40 Carlin Gate, Bispham, Blackpool, Lancashire, FY2 9QT (01253) 596369

Provided and run by:
Column Care (North West) Ltd

All Inspections

2nd and 4th February 2015

During a routine inspection

This inspection took place on 2 and 4 February 2015 and was unannounced.

The service was last inspected in September 2014. They did not meet the requirements of the regulations during that inspection. They breached regulation 9, care and welfare of service users, Regulation 23, supporting workers, and Regulation 10 assessing and monitoring the quality of service provision. The service provider provided an action plan to the Care Quality Commission which showed they would be compliant with these regulations by end of December 2014. However the February 2015 inspection identified there were continued breaches of Regulation 9, care and welfare and Regulation 23, supporting workers. You can see what action we told the provider to take at the back of the full version of the report.

Column Care (North West) Ltd is a detached building located in Bispham, Blackpool. The home is registered to accommodate up to 10 people with mental health needs who require assistance with personal care. At the time of our visit there were seven people who lived at the home. Accommodation was arranged around the ground and first floor. There was a small garden area to the front of the home and a parking area.

There was not a registered manager in place and had not been one for over twelve months. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the registered provider. A condition of Column Care (North West) Ltd’s registration was they had a manager registered with the Care Quality Commission (CQC) in place. You can see what action we told the provider to take at the back of the full version of the report.

People we spoke with told us they felt safe and well cared for. However this did not reflect our findings. Risks were not always assessed and when they were, appropriate action was not always taken to keep people safe. In addition, when we looked at staff files these showed that staff had not all received adult safeguarding training. This meant they did not all have the knowledge to protect people from the risk of poor care. You can see what action we told the provider to take at the back of the full version of the report.

Staff recruitment was unsafe. The way recruitment was carried out increased the risks of unsuitable staff working in the home. You can see what action we told the provider to take at the back of the full version of the report.

The environment was fresh smelling throughout the home. We saw that the cleanliness of the home was adequate in most areas. However people did not have the means to wash and dry their hands appropriately after using the toilet. Liquid soap for hand washing was not in use as it was assessed as a risk. Staff had provided some hard bars of soap but these were ingrained with dirt. There were no disposable hand towels or any other means of drying hands. This increased the risk of poor hygiene and cross infection.

We found people and where appropriate their relatives, were involved in decisions about their care. People had care plans. Some were informative and person centred, others were less so and did not have information about the person’s life history, likes, dislikes and aspirations or information about specific health needs.

At the last inspection the risk assessments carried out did not show what action to take to reduce any risks highlighted. There were no management strategies in place to guide staff in supporting people in vulnerable or high risk situations or with behaviour that challenged. This was still the case at this inspection. You can see what action we told the provider to take at the back of the full version of the report.

When we last inspected staff had not received training in some specific areas of care. We told the provider to arrange for staff to receive training in these areas. At this inspection this training had not been completed. You can see what action we told the provider to take at the back of the full version of the report.

Some procedures had recently been introduced to monitor the quality of the service. The manager had carried out one audit just before the inspection but had not yet acted on the findings. The directors of the Company operating the service did not carry out any quality assurance visits or audits.

People were complimentary about the meals and told us they enjoyed them. The food was well cooked and people were offered a choice of nutritious meals. However no-one was involved in cooking their own meals.

All the people we spoke with confirmed that staff were kind and compassionate. We saw that people’s views were sought on a regular basis. They found the staff team supportive and approachable. One person told us, “They usually listen to us if we aren’t happy with something or want to do something different.”

The management team had policies in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We spoke with the management team to check their understanding of MCA and DoLS. Relevant staff had been trained to understand when an application should be made.

Staffing levels were satisfactory. There were enough staff to provide people with support as needed. However the care practices were not pro-active in involving people and developing new skills and activities.

We looked at how medicines were prepared and administered. We saw medicines were usually given as prescribed. Where they were not and the medicines record had not been signed or errors had been made, the manager had taken appropriate action.

19, 27 August 2014

During a routine inspection

The inspection was led by two inspectors, carried out over two days. Information we gathered during the inspection helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us that Column Care was clean, comfortable and safe. People told us that the staff were helpful and listened to them. Most people told us that the staff were helpful and caring. One person said, 'I like it here. It is better than where I was before. People here are more my age and I get out doing things a lot. The staff are great. ' Another person told us, "The staff are all right. It is all right here sometimes.'

We saw that some people's needs were not always being well met. Staff did not always have the information they needed to provide safe and effective care. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to providing safe and effective care to people.

Staff were aware of The Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made.

There were enough staff on duty during the inspection to support people as they needed. We saw that some people chose to go out and about regularly with staff support as needed.

There was no system in place to make sure that manager and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This increased the likelihood of repeated harm and errors.

Service contracts were in place. Maintenance records we looked at showed that regular safety checks were carried out. Any repairs were completed quickly and safely. These measures ensured the home was maintained.

We looked at the recruitment of new staff. This showed that the required recruitment checks into qualifications and experience were being followed. This assisted the provider in employing suitable staff to care and support people in the home.

Is the service effective?

We had looked at the statement of purpose on the organisation's website which stated Column Care was an acute mental health care, respite and rehabilitation service. However there was little evidence of rehabilitation when we visited or of the structured pathways that the service stated it was providing. This confusion over the purpose of Column Care affected how people were supported. Staff were unsure of the aims of the service they were meant to be providing. This affected the care and support given to people as some people thought Column Care was a home for life.

People's health and care needs were assessed and reviewed with them. We saw that people's care plans were up to date and reflected some current individual, dietary, cultural and religious needs. However some information, particularly in managing risk was not in place and this affected their care and support. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to care records

People confirmed and records showed that people were able to see their visitors in private and that friends and relatives could visit whenever they wished.

The individual needs of people were taken into account with the layout of the home enabling people to move around freely and safely. The premises were suitable to meet the needs of people with physical impairments.

Is the service caring?

We talked with people. They told us that they were well supported by the manager and staff team. They said they could tell them if they were worried about anything or wanted to do things differently. People said they could make their views known to the manager and staff. One person said, 'I can talk to the staff when I want and they take notice of what I want to do.'

We observed staff supporting people. Staff were kind and attentive to people who they treated with respect and dignity. We saw that they showed patience and gave encouragement when supporting people.

Is the service responsive?

Although the statement of purpose and the organisations website stated Column Care was an acute mental health care, respite and rehabilitation service, we saw little evidence of rehabilitation on the inspection. The statement of purpose showed detailed information of therapeutic interventions and pathways; however these were not being carried out. Most people had lived in the home for between four and eight years without moving on.

There was little information for staff on how to reduce the risks with one person who had behaviour that challenged and self-harming behaviour. This meant staff had to rely on their own ideas about how to manage difficult situations, and there was not consistent care and management of these situations. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to acting on people's changing or specific care needs.

People told us that they felt able to tell the manager and staff if they were not happy about anything. They felt that staff listened and made changes when they could.

Is the service well-led?

The service did not have an effective quality assurance system in place. The providers did not have much involvement in the home, even when there had been no manager in post. This meant that the home was not being managed effectively and the providers were not aware of how the home was operating. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to having systems in place to monitor the home.

The new manager was aware of the lack of quality monitoring and planned to develop systems. Staff supervision and staff meetings had commenced. This meant that people had involvement in decisions about the home.

CQC had not always been notified of any incidents or issues relating to the home in a timely manner. This meant that we did not receive all the information about the home that we should have done. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to providing information as required.

24 April 2013

During a routine inspection

We spoke individually with the provider, staff and people receiving care at the home. We asked people to tell us about their experiences of living at Column Care. We reviewed care records, policies and procedures, audits and risk assessment documentation.

One person told us, 'Staff are very good and supportive'. Another person said, 'I'm very happy here'. We observed care being provided in a respectful way because the staff and manager worked as an organised team

The service demonstrated good practice that ensured a safe, clean environment. Staff worked with other providers to ensure continuity of people's care. People felt safe because of strong leadership and properly recruited, trained and qualified staff.

The provider ensured that the service's quality monitoring was undertaken by having various audits and checks in place. People consented to and understood their treatment because of good practice within the service.

22 November 2012

During a routine inspection

At the time of our visit to Column Care there were ten people living at the home. One individual agreed to speak with us initially. However, it was not possible to obtain any comments on this occasion. The provider might like to note that a second individual asked to speak with us later in the day when some concerns were raised. We discussed these with the manager, who agreed to use the home's procedures to address the issues highlighted.

We found people's privacy and dignity were, in general respected and those living at Column Care were able to make decisions about what they did and how they wished to be supported, with their independence being promoted. We found medications, in general, to be managed well and staff received good managerial support in the form of induction programmes, supervision and training.

31 January 2012

During a routine inspection

People told us they could express their views and were involved in decisions about their care. They said they had been involved in the process of gathering information about their needs and consented to live at the home. They said there were regular reviews of their care and they attended meetings with their care coordinator to review the care being provided for them.

We spoke to people about their experiences living in the home and were told the staff team provided flexible personal care support and they felt well cared for. They told us routines were flexible and they could get up and go to bed when they wished. They said the standard of food was very good and there was a variety of food from which to choose.

A family member spoke to us about the care their relative received and said they were having a 'trial run' but after four months they were settled and said, "He says he likes it here. He tells me everything is OK and he hasn't said anything negative. He says the staff are nice and has plenty to do. We talk on the telephone and doesn't say much usually but I can see he's better. I've visited him several times and am always welcomed. The place is clean, relaxed and a friendly atmosphere. I have lunch with him and he seems happy. He has gone to the cinema this afternoon with staff".

People told us they were safe and cared for and said, "I didn't want to be here at first. I have tried and yes it's been alright". And "I'm going to stay here for a while and don't mind. I must be better as my health has improved and I can go out without staff".