Background to this inspection
Updated
6 April 2024
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 Health and Social Care Act 2008.
Inspection team
This inspection was carried out by 2 inspections and a medicines inspector.
Service and service type
Haydock House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Haydock House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
During the time of our inspection a manager became registered with CQC.
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since its registration. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 5 people who used the service about their experience of the care provided. We spoke with 7 members of staff including care staff, the registered manager and 2 members of the senior management team including the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included people's care and medicines records. A variety of records relating to the management of the service, including monitoring and reviewing information, were also reviewed.
Updated
6 April 2024
About the service
Haydock House is a residential care home providing regulated activity of personal care for up to 16 people. The service provides support to people over the age of 18 with mental health needs. Accommodation is provided over two floors of the building. At the time of our inspection there were 11 people using the service.
People’s experience of using this service and what we found
People's safety was not always appropriately managed. Identified risks to people were not always considered or planned for. Medicines were not always managed appropriately. Staff supporting people were not always familiar with their individual needs and there was a lack of guidance and support available of how to support people safely. Safeguarding concerns, incidents and accidents were not always appropriately recorded or reported to other agencies.
People’s needs were not always assessed in full and information supplied by other agencies was not always considered in planning people’s care and support needs. People were not always supported by staff who had the relevant skills; communication; training and experience to meet their needs.
People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Information available to staff was limited and failed to give sufficient guidance on how to engage with people and promote community presence.
People's care and support was not planned in a person-centred way which promoted their choice, control or preferences. People’s care plans failed to show that their current and long-term aspirations had been considered or planned for. There was no evidence to show that people were encouraged to widen their social circles within local communities or to pursue and develop hobbies and interests.
Records were not always fit for purpose and put people at serious risk of not receiving the care, treatment and support they needed. The providers audits and checks in place had failed to identify areas of improvements, and take the actions needed identified during this inspection. No effective systems were in place to ensure that people were supported by staff who had the skills to meet the needs of people.
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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support: People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Right Care: Care was not person-centred or promoted people’s dignity, privacy and human rights
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff failed to ensure people using services lead confident, inclusive and empowered lives.
Following the inspection the provider took action to address the most serious concerns identified during the visits.
Rating at last inspection
This service was registered with us on 15 November 2022 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service and other information of concern raised by another agency.
The overall rating for the service is inadequate based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe; effective; caring; responsive 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.
Enforcement and Recommendations
We have identified breaches in relation to risk management; medicines; staffing; training; person centred care; management and oversight at this inspection. We have made recommendations in relation to the oversight of the Mental Capacity Act and the services environment.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.