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Archived: Bellus Lodge Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 21 June 2017

The inspection took place on 29 February 2017 and was announced. The inspection continued on 2 March 2017.

We carried out an announced comprehensive inspection of this service on 5 April and 6 April 2016. After that inspection we received concerns in relation to the care and support of people and management of the home. As a result we undertook another comprehensive inspection.

Bellus Lodge provides accommodation and personal care to people with learning disabilities and behaviour support needs. It is registered for up to six people. At the time of our inspection there were six people living there. There were two bedrooms on the ground floor and four bedrooms on the first floor. There was a main kitchen and open plan living and dining area. This led into an enclosed garden and patio area.

As a condition of registration the service must have a registered manager. 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. There had been changes in the management of the home immediately prior to this inspection. The manager registered with us no longer managed the carrying on the regulated activity.

Bellus Lodge was not always a safe place for people to live. Safeguarding systems and processes in place were not established and did not operate effectively to prevent potential abuse of people.

Risks were not always managed safely. Risk assessments were not always followed appropriately and several staff told us they had not read these. We found that injuries and marks were not always recorded or reported.

People were not always receiving care from staff that were competent, skilled and experienced. There was a risk that people were receiving care from staff who had not had training to meet the needs of people with learning disabilities and complex behaviour. People were being physically restrained and administered medicines by untrained staff. People received bruising following restraint by untrained staff. This left people at risk of unsafe care and treatment because staff did not have the appropriate training and knowledge to provide effective care.

Information regarding pre-employment checks was not available to us during the inspection.

People's rights were not always protected under the Mental Capacity Act 2005 (MCA), and the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty they have been authorised by the local authority as being required to protect them from harm. Assessments had not been completed specific to the decision that needed to be made around people's capacity. DoLS applications had been submitted to the local authority.

People were not always supported effectively in relation to their nutritional needs or continued health care. Plans and guidelines were not being followed by staff. Staff confirmed that menus did not always reflect people’s food likes and dislikes. People were not always supported to access health care services appropriately.

Positive caring relationships were not always established between people who lived at Bellus Lodge and staff members working with them. We found that staff had not read people’s files and did not know everyone they supported.

Staff at the Bellus Lodge did not always treat people with dignity and respect. Care and support was not always delivered privately. There were times where people were watched and observed for periods of time throughout the day. There was evidence of lack of interaction and choices for people at the service around how their care was to be delivered.

The service was not always responsive to people’s health, social and recreational needs. Care plans and as

Inspection areas

Safe

Inadequate

Updated 21 June 2017

The service was not safe.

There were not enough suitably trained staff deployed at the service to meet

people's needs and keep them safe.

People were not always safe because safeguarding systems and processes in place were not established and did not operate effectively to prevent potential abuse to people.

Staff were not aware of their roles and responsibilities in how to protect people.

People were not protected because safe recruitment practice was not being followed.

Medicines were not managed safely and were administered by untrained staff.

Effective

Inadequate

Updated 21 June 2017

The service was not effective.

People were not always supported by staff that had the necessary skills and knowledge to meet their assessed needs.

Staff did not understand how to apply legislation that supported people to consent to treatment. Where restrictions were in place this was not always in line with appropriate guidelines.

People were not always supported to maintain healthy diets or follow professional�s advice.

People were not always supported appropriately to have access to healthcare services.

Caring

Inadequate

Updated 21 June 2017

The service was not always caring.

People were not supported by staff that made time for them.

People were not supported by staff that always used person centred approaches to deliver the care and support they provided.

Staff did not all have a good understanding of the people they cared for and supported them in decisions about how they liked to live their lives.

People were not always supported by staff who respected their privacy and dignity.

Responsive

Inadequate

Updated 21 June 2017

The service was not responsive. Care files were not personalised. Outcomes and goals were not set or up to date and regularly reviewed.

People were supported by staff that did not always recognise and responded to their changing needs.

There were no active systems in place for people, relatives or professionals to feedback to the service.

Complaints had been made but inappropriate action or no action at all had been taken to address these.

People did not always have access to activities that were important and

relevant to them.

Well-led

Inadequate

Updated 21 June 2017

The service was not well led.

Systems and processes to monitor safety and quality of care in place were ineffective and not robust.

Accurate and contemporaneous records were not always kept.

People received poor standards of care and staff told us they felt unsupported by the management.

A positive, open and empowering culture was not promoted or embedded at the home. Professional boundaries were not established due to a lack of good management and leadership.

Appropriate notifications were not sent to the CQC.