Background to this inspection
Updated
31 October 2018
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.
The inspection took place over two days on 26 October and 10 November 2016 and was unannounced on both days. The home was last inspected in February 2015, when it was found to be requires improvement in all the key lines of enquiry. The home was inspected as there had been serious concerns brought to our attention from the commissioning authority in relation to the safety of the care which was being provided in the home.
The inspection was carried out by two adult social care inspectors and an expert-by-experience on the first day, on the second day there were two adult social care inspectors. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience of adult care settings and people with dementia.
Prior to the inspection we reviewed all information we hold on the home, and sought feedback from the commissioning authority and other professionals who worked with the home. We did not request a provider information return due to the inspection being brought forward in response to information of concern being received.
During the inspection we spoke with 11 people who lived at the home and six relatives who visited the home. We spoke with five members of care staff, one senior care worker, the interim manager and the owners of the home.
We reviewed records relating to all areas of the service including, the care files for eight people, staff recruitment files for four staff, training and supervision records, safeguarding records, complaints, risk assessments and medication administration records for every person who lived at the home. We also examined safety certificates, policies and procedures which were in place.
Updated
31 October 2018
The inspection took place over two days on 26 October and 10 November 2016 and was unannounced. The home was last inspected in February 2015, when it was found to be requires improvement in all the key lines of enquiry.
Croft Acres is a home offering accommodation over two floors for up to 25 older people and people living with dementia who require personal care and support. At the time of the inspection there were 19 people living at the home.
There was no registered manager in post at the time of the inspection. There was a manager who was absent from the service, and an interim manager who was responsible for the day to day running of the home in the manager’s absence.
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.
The provider was not meeting the requirements of ten regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and one requirement of the Care Quality Commission (Registration) Regulations 2009. We are currently considering our options in relation to enforcement and will update the section at the end of this report once any action has concluded.
The service was not recognising incidents which put people at risk of harm and was not taking all reasonable measures to keep people safe.
Risk assessments where they were in place were not correctly filled out and did not identify specific risks or demonstrate the measures needed to mitigate those risks.
Medicines were not managed safely. People were not all receiving their medicines as prescribed.
There were not always sufficient staff on duty to meet people’s needs safely. Staff were not well-trained or supported.
Recruitment processes were not adhered to and the required pre-employment checks were not always carried out prior to people commencing work.
The service was not protecting people’s rights and working within the Mental Capacity Act 2005.
Food was not always of good quality and people did not all receive the required support to help them eat and drink adequately.
Staff were kind and caring, however did not always recognise when people were not being treated with dignity and respect.
People were not encouraged to be independent. Care was task orientated and had some institutionalised elements.
Care plans were not person centred. There was very little evidence of personal information being gathered and available for staff. Care plans were not reviewed to ensure they were up to date and included all current information.
There were activities in the home, however these did not meet the needs of some of the people in the home and were not helpful to people living with dementia. There were no opportunities offered for people to leave the home on outings.
The management of the home had been unstable and people and their relatives had lost confidence. People were not sure who the current manager was.
There were no processes in place to monitor the quality and safety of the service. The registered providers did not have any oversight of the performance of the home or the staff who worked there.
Records were of very poor quality and did not fulfil their purpose.
The overall rating for this service is ‘Inadequate’ and the service is therefore 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.