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Archived: Cascade 4 - Newick Road Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 27 May 2015

We carried out an unannounced comprehensive inspection of this service on 3 December 2014. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to people’s safety, nutrition, infection control, care and welfare, quality monitoring, medicines management, notifications, respect and consideration, consent and staff training and support.

We undertook this focused inspection to check that the provider had followed their plan in relation to the more serious breaches that related to safety, nutrition, infection control, care and welfare and quality monitoring and to confirm that they have now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk.

Cascade 4 Newick Road is a care home providing 24 hour care, support and accommodation for up to five people with mental health needs. The provider has a number of other care homes in the local area. At the time of our inspection there were three people using the service, this was because the home was preparing to close and alternative suitable placements were being sought for people to move on to.

This focused inspection took place on 19 March 2015 and was unannounced. Since our last inspection the registered manager had left and an interim manager had been appointed by the provider. 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 and associated Regulations about how the service is run.

During our last inspection we found that people were not kept safe as risks posed by visitors and behaviour that challenged the service were not managed appropriately. At this inspection we found that steps had been taken to manage risks such as smoking, the impact of visitors to the service and monitoring people’s mental health and wellbeing. We found that safeguarding incidents were been appropriately reported and addressed.

Previously we found that standards of cleanliness were poor and systems were not in place to control and prevent the spread of infection. In particular the kitchen was unclean. We found that cleaning schedules had been introduced to address this and saw that standards of cleanliness had improved which people we spoke with confirmed.

During our last inspection we found that there was not enough food available to support good nutrition and people were restricted from accessing the kitchen at night which meant they were unable to make snacks or drinks without asking for staff permission. Since our last inspection changes had been made to improve the quantity of food available. We found that there was a good selection of food including fresh fruit and vegetables and snacks that people could help themselves to. People told us that they had been involved in cooking sessions and confirmed that there was more food available.

Previously the provider had failed to assess, meet and review people’s needs appropriately. Care plans were incomplete in that they did not fully outline people’s current needs and the action staff should take to meet these. However, during this inspection we found that people’s care plans had been updated and were being reviewed at regular intervals. We saw that people had been involved in this process and contributed their thoughts on the support they felt they required.

We found that staff had begun to explore people’s leisure interests to support their engagement in the community and a weekly in-house ‘cinema night’ had been introduced which people told us they enjoyed.

At our last inspection we found that quality monitoring systems were ineffective as they did not always identify or address issues. During this inspection we found that more robust quality assurance systems had been introduced which had supported some improvements to the service.

At our previous comprehensive inspection on 3 December 2014 we also found breaches of legal requirements relating to medicines, staff training, consent, notifications of significant events and respecting people that use services. If the service does not close as planned we will carry out another unannounced inspection to check on all outstanding legal breaches.

Inspection areas

Safe

Inadequate

Updated 27 May 2015

We found that action had been taken to improve the safety of this service. Risks were being managed in a way that helped to keep people safe.

Safeguarding concerns were reported to the relevant authorities as required.

There were systems in place to prevent and control the spread of infection and we observed satisfactory standards of cleanliness.

We could not improve the rating for safe from inadequate because to do so requires consistent good practice over time and compliance with the outstanding breaches identified at our comprehensive inspection on 3 December 2014. We will carry out a further inspection to review the outstanding breaches.

Effective

Inadequate

Updated 27 May 2015

We found that action had been taken to improve the effectiveness of this service. People’s nutritional needs were being met and there were good supplies of food including fresh fruit and vegetables available.

People told us they were able to access the kitchen at all times and prepare snacks and drinks.

We could not improve the rating for effective from inadequate because to do so requires consistent good practice over time and compliance with the outstanding breaches identified at our comprehensive inspection on 3 December 2014. We will carry out a further inspection to review the outstanding breaches.

Caring

Inadequate

Updated 27 May 2015

Responsive

Inadequate

Updated 27 May 2015

We found that action had been taken to improve the responsiveness of this service. People’s needs were assessed and care plans had been updated to ensure that they contained accurate information about people’s needs and the actions staff should take to meet these.

We could not improve the rating for responsive from inadequate because to do so requires consistent good practice over time. We will carry out a further inspection to review this.

Well-led

Inadequate

Updated 27 May 2015

We found that action had been taken to improve the leadership of this service. Quality assurance systems had been improved and action had been taken to improve the service.

There was a new manager in post at the time of our inspection.

We could not improve the rating for well led from inadequate because to do so requires consistent good practice over time and compliance with the outstanding breaches identified at our comprehensive inspection on 3 December 2014. We will carry out a further inspection to review the outstanding breaches.