16 June 2016
During a routine inspection
We carried out a further focussed inspection of the service on 21 April 2016 to check that the provider had made and sustained the improvements they had told us they would make. At this inspection we found that the provider had failed to make the improvements they told us about. We also identified some other concerns which we raised with the provider on the day.
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 immediately action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to being the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.
Rose Villa Nursing Home provides accommodation and nursing care for up to 27 older people or people with physical disabilities. At the time of our inspection, 11 people were living at the home.
There was a manager in post, but she had recently been appointed and was not registered with the Care Quality Commission. 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.
Fire risk assessments were not in place to ensure staff were aware of their roles and responsibilities in the event of a fire. The call bell system on the first floor was not fit for purpose and did not enable staff to respond to people’s needs in a timely manner.
Not all risks assessments in place for moving and handling involving equipment had been completed in line with the manufacturer’s guidelines, leaving people at risk of harm.
People’s medical conditions were not always treated appropriately by the use of their medication.
People were not adequately protected from the risk of infection control and requirements of a recent infection prevention action plan had not been met.
People were not supported in a timely manner as staff were required to cook meals as well as care for people. A shortage of nursing staff meant the manager regularly worked on shift to cover staff absences and was unable to drive forward the improvements required in the home.
Staff did not receive an induction and training that provided them with the knowledge and skills they required to safely meet the needs of the people they supported.
People did not receive a choice of meals and the quality of food provided was poor and not nutritious.
Staff gained people’s consent before providing them with care and support, but lacked knowledge of legislation protecting people’s rights.
People were supported to access healthcare services, but some staff failed to pass on information regarding people’s healthcare needs to new staff coming onto shift.
People were supported by staff who were caring and kind, but people’s dignity was not always maintained.
People were not involved in the planning of their care or asked how they preferred to be supported or spend their time. There were no activities taking place in the home and no stimulation for people on a daily basis.
There was a system in place to record people’s complaints, but there was no information available advising people how to do this and people were not aware of it.
People spoke highly of the manager and felt supported by her, but felt that she lacked support from the provider.
The provider had failed to take responsibility for the day to day running of the home and to offer support to the manager and the staff. The provider had failed to ensure the requirements of the action plan that was in place had been fully met.
We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.