Archived: Grace Care/Training Limited

The focussed inspection was unannounced and took place on 7 July 2016. The registered manager was in the process of deregistering with the Commission as they no longer worked at the service. 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.

Previously we carried out an announced comprehensive inspection of the service on 5 May 2016 and found that nine legal requirements had been breached. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Grace Care training Limited on our website at www.cqc.org.uk

Following the inspection, we requested that they provided an action plan setting out what they would do to meet the legal requirements and we imposed conditions on their registration with us.

We undertook this focussed inspection to check that the provider had followed their action plan to meet the legal requirements. We found at this inspection that the provider had not taken the necessary action and were not meeting the requirements.

The service did not have appropriate systems in place to protect people from harm. Staff recruitment processes were not robust and the necessary checks had not been undertaken to ensure staff had been recruited safely.

Risks to people’s health and wellbeing were not appropriately mitigated and managed. People did not get their nutritional needs met to keep them well as visits to people were missed or late.

The safe management of medicines was not in place with the required checks about the competence of staff skills and abilities to assist people with their medicines.

Staff did not receive the required induction, training, supervision and support to undertake their role.

There was not sufficient leadership of the service in place. Quality assurance and management systems were not developed to monitor the care provided to people who used the service.

People’s views were not taken into account and used to make improvements to the service. Processes were not in place to deal with people’s complaints and concerns.

A registered manager was in place but was not available on the date of the inspection as they had resigned two days before the inspection took place. 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.

The service did not have appropriate systems in place to protect people from harm. Staff recruitment processes were not robust and the necessary checks had not been undertaken to ensure staff had been recruited safely.

Risks to people’s health and wellbeing were not appropriately assessed and reviewed. Care plans were not sufficiently detailed to provide an accurate description of people’s care and support needs.

The safe management of medicines was not in place with the required checks about the competence of staff skills and abilities. People were at risk as they did not consent to their medicines being given. People were not supported to meet their nutritional needs to keep them well.

Staff did not receive the required induction, training, supervision and support to undertake their role. There were staff working at the service without the knowledge and skills to provide people with safe care and treatment.

Staff did not always treat people with respect, were not always attentive to people’s needs or maintained their dignity in the way they provided care and support.

There was no overall leadership of the service in place. Quality assurance and management systems were not in place to monitor the care provided to people who used the service.

People’s views were not taken into account and used to make improvements to the service. Processes were not in place to deal with people’s complaints and concerns.

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.