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Archived: Waterbeach Requires improvement

The provider of this service changed - see old profile

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Reports


Inspection carried out on 19 April 2016

During a routine inspection

Waterbeach is registered to provide accommodation and non-nursing care for up to 4 people. There were 4 people with a learning disability living in the home at the time of the inspection. The accommodation is a bungalow and all bedrooms are for single use.

This unannounced inspection took place on 19 and 20 April 2016.

At the last comprehensive inspection on 12 and 13 October 2015 this provider was placed into special measures by CQC. A breach of nine legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to:

• providing care that was appropriate, safe and met people’s needs,

• treating people with dignity and respect,

• ensuring that the requirements of the Mental Capacity Act 2005 were met

• safe management of people’s medicines,

• maintaining the premises,

• assessment and monitoring of the service,

• sufficient numbers of competent staff to meet peoples assessed needs.

During this inspection we found that there was sufficient improvement to take the provider out of special measures. We found that the provider had followed their plan which they had told us would be completed by 31 March 2016 to show how the legal requirements were to be met. Some improvements were still needed.

There was a registered manager at the time of the inspection. However they were no longer working in the home. A new manager had recently been appointed. 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.

Improvements had been made to ensure that only competent staff administered medicines. Weekly and monthly medicines audits were being carried out and had highlighted any issues and appropriate action had been taken where necessary. Improvements were still needed to ensure that there was a clear record of the medicines in stock.

The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was acting in accordance with the requirements of the MCA including the DoLS. The provider was able to demonstrate how they supported people to make decisions about their care. Where people were unable to do so, there were records showing that decisions were being taken in their best interests. DoLS applications had been submitted to the appropriate authority. This meant that people did not have restrictions placed on them without the correct procedures being followed.

People’s care plans had been updated to include information that staff required to meet people’s needs. We found that some information was still not accurate. However we found that staff could tell us how they met people’s needs. All of the care plans were being transferred to a new format which should make them easier to use and contain up to date accurate information..

Risks to people had been assessed. The majority of the risk assessments identified how staff should reduce the possibility of risks to people. Some risk assessments needed further information adding to them to ensure that staff had all the information they required to ensure that risks to people were identified and minimised where possible. Accidents were being were being reviewed to prevent a reoccurrence.

There was a robust recruitment procedure to ensure that only the right people were employed. There was a sufficient number of suitably skilled and competent staff working each day. Staff had completed training courses and competency assessments since the previous inspection to ensure that they could meet people’s needs. Staff were aware of the procedures to follow to reduce the risks of people being harmed b

Inspection carried out on 12 & 13 October 2015

During a routine inspection

Waterbeach is registered to provide accommodation and non-nursing care for up to 4 people. There were 4 people with a learning disability living in the home at the time of the inspection. The accommodation is a bungalow and all bedrooms are for single use.

This unannounced inspection took place on 12 and 13 October 2015.

At the time of the inspection there was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The system to monitor the quality of the care being provided and to drive improvement was not effective and this impacted on all areas of the service.

Risks had not always been managed to keep people as safe as possible. Risk assessments had not always been completed when necessary. This meant that staff did not have the information they required to ensure that people received safe care.

Accidents and incidents were not continually reviewed to identify and address patterns or common themes. We could not be confident that people were receiving their medication as prescribed. Not all staff who administered medication had been trained and assessed as being competent. Current legislation was not being followed regarding the storage and recording of administration of medication. Medication audits were not being completed to identify any areas for improvement.

A system to make sure that there were enough staff available to meet peoples’ needs at all times was not in operation. Action had not been taken in a timely manner to maintain the building. Contingency plans were in place so that staff knew what action to take in the event of an emergency.

The recruitment procedure hadn’t always been followed. This meant that one person had been employed before all of the relevant checks had been completed. Staff were receiving regular supervisions.

The registered manager was not aware of what training or competency assessments some staff had completed. Not all staff had received the training that they required to meet people’s assessed needs. This placed people at risk of receiving care that was inappropriate. Staff were aware of the procedure to follow if they thought someone had been harmed in any way.

Although staff had made referrals to health professionals the information that they received was not always followed.

The requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) had not been complied with. This meant that where people were being restricted from leaving the home on their own to ensure their safety, this had not always been done in line with the legal requirements. Staff did not have a good understanding of the principles of people being assessed as having capacity or making best interest decisions.

People’s dignity, respect and privacy was not always maintained. People’s records were not held securely and confidential information was accessible to other people and visitors to the service.

Adequate food and drink was provided. However people were not always offered choices about what they would like to eat and drink. Staff did not always follow the guidance provided by the speech and language therapist about suitable diets.

Care plans did not contain all of the relevant information that staff required so that they knew how to meet people’s current needs. We could not be confident that people always received the care and support that they needed. People were not encouraged and supported to take part in a range of activities that they may enjoy.

The provider and registered manager were not aware of the shortfalls in the quality of the service we found at the inspection Although the provider had stated that they would carry out checks of the service on a six weekly basis these had not always been completed..

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 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 begin 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.