Archived: Woodford Care Home

Updated 2 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 20, 22 and 29 September 2016 and was completed by one adult social care inspector.

Before the inspection, we contacted the local authority commissioning, safeguarding and environmental health teams to gain their views on the service. We reviewed all of the information we held regarding the service, including notifications and previous inspection reports.

During the inspection, we spoke with six people who used the service and five visiting relatives.

We also spoke with the nominated individual, the acting manager and nine members of staff, including care and domestic staff and the cook.

We looked at seven people's care plans along with the associated risk assessments and medication administration records (MARs). We also looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that when people were assessed as lacking capacity to make informed decisions themselves or when they were deprived of their liberty, actions were taken in their best interest.

We looked at a selection of documentation pertaining to the management and running of the service. This included quality assurance information, recruitment documentation for six members of staff, the staff training records as well as a number the registered provider's policies and procedures.

Updated 2 February 2017

Woodford Care Home is situated on a main road in Hull and consists of three combined terraced houses. It is registered to provide accommodation and personal care for up to 18 people. The home has a mixture of single and shared bedrooms over two floors. Communal rooms consist of a main lounge, an additional smaller lounge and a dining room. There is also a third room, used as a thoroughfare that has two easy chairs. There are several bathrooms, although only one has an assisted bath. At the time of the inspection, there were 13 people using the service.

This unannounced comprehensive inspection took place on 20, 22 and 29 September 2016. The inspection was carried out by one adult social care inspector. At the last inspection of the service in August 2015, the registered provider had achieved compliance with the regulations we had found to be non-complaint during inspections carried out in February and May 2015.

There was no registered manager in post at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

A registered manager left the service in April 2016. A manager was recruited who began the application process to become the registered manager but they left the service in August 2016. A senior carer was then promoted and is referred to as the ‘acting manager’ throughout this report.

During this inspection, we found that the registered provider had failed to sustain the improvements we found at the last inspection of the service in August 2015.

We found multiple breaches of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 immediate action to propose to cancel the registered provider's registration of the service, will be inspected again within six months. The expectation is that registered 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 begin the process of preventing the registered 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 registered provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

The infection control practices within the service increased the risk of people contracting a healthcare related infection. Staff carried soiled laundry through the home and we saw used incontinent pads left on the shelving in people’s rooms. The extractor fan in the main bathroom/toilet, which is situated off the main lounge and adjacent to the kitchen; was not working at the start of our inspection this increased the risk of air borne spoors contaminating the lounge and the kitchen.

The environment was not maintained effectively to ensure the safety and welfare of the people who used the service. Vulnerable people had access to water temperatures that could have burnt or scalded them because the registered provider had failed to ensure safe water temperatures were maintained.

Safe recruitment practices were not followed. The registered provider had failed to assure themselves that prospective staff were suitable to work with vulnerable adults because they failed to undertake Disclosure and Barring Service (DBS) checks or acquire suitable references before staff commenced working with vulnerable people autonomously.

Staff with relevant training, skills and abilities were not always deployed. We cross-referenced the staffing rotas and staff training records and saw that on numerous occasions during July, August and September 2016 staff working the night shift had not completed important training. This included dementia, infection control, health and safety, fire, first aid, food hygiene, the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS) or medication training. This exposed people to the risk of not receiving the care and support they were assessed as requiring.

Staff were not supported effectively and had not received regular supervision, appraisal or professional development.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of adults by ensuring if there are restrictions on their freedom and liberty, these are assessed by appropriately trained professionals. The registered provider had not fulfilled their responsibilities in relation to DoLS; they had failed to identify who met the criteria for DoLS and to submit applications to the supervisory body as required. This meant that people who used the service may be unlawfully restricted.

People were supported to eat and drink sufficiently to meet their needs but we found choices of meals were limited and people were not always offered alternatives if they did not want to eat the main meal options.

During the inspection, we observed a range of care and support and witnessed staff supporting people and meeting their needs in a caring way. However, we also witnessed staff not responding to people’s questions or requests in a caring way and noted that, on more than one occasion staff actions failed to maintain people’s dignity.

People’s care plans did not reflect their current level of needs and we found two people had not had a care plan created by the service. This meant staff may not be fully aware of people’s needs or the care and support they required.

The registered provider had a complaints policy that included acknowledgement, investigation and response times. The policy was made available to people who used the service.

There was no evidence that any form of auditing or quality assurance had taken place within the service between April and September 2016. The acting manager had completed tests of the emergency call bell systems in three random rooms and undertaken infection prevention and control audits on three occasions in September 2016. However, the audits failed to highlight the concerns found during our inspection and their findings were not sufficient to drive improvement within the service.

The registered provider had failed to adhere to advice and guidance provided by relevant persons such as the local fire authority and the environmental health team.