22 June 2017
During a routine inspection
There was a registered manager in post. 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.
We carried out an announced comprehensive inspection of this service in November 2015. After that inspection we received concerns in relation to how people were being protected from abuse and neglect. As a result we undertook a focused inspection to look into those concerns. This was extended to a comprehensive inspection as additional risks were identified.
Staff skills were not appropriately checked and this meant the provider and people could not be assured that staff had the skills and knowledge to care for the safely.
People were supported by staff who had been trained in how to respond to abuse, but the staff in the office had not received this training and safeguarding concerns were not always identified and addressed appropriately. Notifications that the service was legally required to make to the CQC had not always been made when abuse had been alleged.
People told us they received their medicines safely, however the systems were not always operated effectively to support the safe administration of medicines and staff competency was not sufficiently assessed.
Care staff had received training in the Mental Capacity Act 2005 (MCA). However staff did not all understand and implement the principles of the MCA and this meant people were at risk of not having their human rights respected.
People mostly had their privacy and dignity maintained although systems to return records to the office did not protect people’s confidential information.
People had been involved in developing individual care plans which took into account their likes, dislikes and preferences. These care plans and records covered people’s social, emotional and health needs including access to health care. These were not always updated effectively and this put people at risk of receiving inappropriate care.
There was a clear management team and staff had defined roles and responsibilities that supported providing person centred care. There was not sufficient capacity in this team to ensure the efficacy of the oversight systems and issues identified during our inspection had not been picked up by internal quality assurance.
People knew how to make a complaint and where they had made complaints these had usually been responded to appropriately. We found examples of learning opportunities from complaints.
People were comfortable with most staff and, where they had regular care staff, had formed positive relationships. They told us they were usually cared for by staff who treated them kindly and with respect.
CQC has taken action to vary the provider’s conditions of registration. The provider is required to submit a report to CQC on a monthly basis, setting out the action take to address shortfalls in risk management, protecting people from abuse, staff competency and deployment and quality assurance.