Background to this inspection
Updated
27 October 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
37 Spenser Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the provider less than 24 hours’ notice of the inspection. This was to check if any staff or people at the service had tested positive or had symptoms of COVID-19 and to discuss arrangements for the inspection and PPE required.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with two people who used the service about their experience of the care provided. We spoke with ten members of staff including the provider, manager of another of the providers services, senior care workers, care worker.
We reviewed a range of records. This included nine people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection –
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who have visited the service.
Updated
27 October 2021
About the service
Optima Care Limited - 37 Spenser Road is a 'care home' providing personal care for up to 13 people with a with a learning disability and physical disabilities. At the time of our inspection 10 people were living at the service.
People’s experience of using this service and what we found
People were not protected against risks associated with their care. The environment and equipment were not always clean or properly maintained. These concerns were raised at the last inspection but had not been addressed. Staff were not always raising concerns around about neglect and abuse. The local authority were not always being informed when safeguarding incidents occurred.
People’s medicines were not always being managed in a safe way. Accidents and incidents were not always recorded, and not enough action was taken to reduce further risks to people.
There was an insufficient number of staff deployed to ensure that people received their care when needed. The registered manager and provider did not have appropriate systems in place to review the dependencies of people to ensure sufficient staff were on duty.
The leadership at the service was not robust and there was a lack of auditing to review the quality of care provided. Staff did not always feel supported or valued. Notifications were not always being sent to the CQC when it was appropriate to do so.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People were not always supported with their independence. Staff did not always have an understanding of the support and care people needed to enable them to have a fulfilled life. The was a closed culture at the service where practices were at time institutionalised.
Right support:
• Model of care and setting did not maximise people’s choice, control and Independence
Right care:
• Care was not person-centred and did not promotes people’s dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff did not ensure people using services lead confident, inclusive and empowered lives
Following this inspection, we worked closely with the local authority (Kent County Council) and the Clinical Commissioning Group (CCG) to ensure people were safeguarded from ongoing harm. Alternative placements are being sought for some people.
Rating at last inspection (and update)
The last rating for this service was Inadequate (published 22 October 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found sufficient improvements had not been made and the provider remained in breach of regulations.
This service has been in Special Measures since 22 October 2020. During this inspection the provider was unable to demonstrate that improvements had been made. The service is rated as inadequate in the key questions Safe and Well Led. Therefore, this service remains in Special Measures
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We received concerns in relation to people not being safeguarded from the risk of abuse. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the Safe, and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Optima Care Limited - 37 Spenser Road on our website at www.cqc.org.uk.
Enforcement We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to people not being protected from the risk of neglect and abuse, risks related to the care being provided to people, the lack of suitably qualified staff and the lack of robust provider and management oversight at this inspection.
We took action against the provider and cancelled their registration for Optima Care Limited - 37 Spenser Road. Everyone moved out of the service, and we have de-registered Optima Care Limited - 37 Spenser Road with the Care Quality Commission.