The manager had been in post at Hathaway House for approximately 12 months. They had not yet applied to Care Quality Commission to be the registered manager. The manager told us they were told they were in the process of registering. We discussed this with the provider, they told us they were unaware the manager was not registered with CQC.
The warning notice had been issued in relation to assessing and monitoring the quality of service provision. We saw the on going development of systems was in place to identify and monitor the quality of the service provided at the home. We saw where risk assessments had been completed, identified controls to reduce the level of risk were in place.
A system must be in place to ensure consent is sought for the care, treatment and support of people who use the service. We saw the manager had taken steps to obtain and record the consent of the person using the service or, where appropriate, from a person or persons who had sufficient knowledge to make decisions in the person's best interest.
When we visited the manager was unavailable. During our last inspection we were told that they were in the process of registering the manager with us the Care Quality Commission (CQC). At that time the manager had been in post for eight weeks. To date the manager has not submitted a registration application to CQC.
During this inspection we did not see the service had arrangements in place for obtaining, recording and acting in accordance with the consent of the person using the service or, where appropriate, from a person or persons who had sufficient knowledge to make decisions in the person's best interest.
We saw where risk assessments had been completed, identified controls to reduce the level of risk were not in place. Systems were not in place for the service to identify and monitor the quality of the service provided at the home.
The local authority had raised concerns about the quality and the safety of the service. These concerns had been investigated and monitored by the local authority safeguarding team, along with other relevant professionals. During this time the local authority had stopped new placements of people into this home. At the time of our visit the local authority had removed the suspension of placements and were continuing to support and monitor the service.
There was a new manager in post when we visited. The manager was in the process of registering as the manager with us the Care Quality Commission (CQC). The manager had been in post for eight weeks.
We carried out this review to check on the care and welfare of people using this service. We visited Hathaway House in order to up date the information we hold and to establish that the needs of people using the service were being met. The visit was unannounced which meant the provider and the staff did not know we were coming.
During our visit we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not able to tell us their experiences, for example observations. We spoke with three members of staff, the manager and the provider and following our visit we contacted family members of people who use the service. We also spoke with two health professionals who had visited the service.
During the inspection we looked at how the organisation respected and involved people who used the service. We saw that plans of care recorded people's needs views and experience in relation to the way that the service provided and delivered their care.
We looked at how people who use the service receive their care treatment. We observed care delivery and saw that the support offered by staff reflected the information held in care plans. We saw, for example, prompts being given to encourage a person with household tasks. Care plans did not include details of how consent to care delivery was obtained.
An organisation must ensure that staff and people who use the service understand safeguarding (protecting vulnerable adults). We saw training records that evidenced most staff had received training in safeguarding. The staff we spoke with said they were confident to raise any safeguard concern with the appropriate person.
The service did not have adequate systems in place to monitor the quality of the care and treatment the service delivers. Systems for quality monitoring were being developed by the new manager and were not yet in place. We were therefore unable to confirm compliance in this area.