Archived: Harold Community Centre

This inspection took place on 12 April 2018 and was announced. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. The inspection team consisted of one inspector.

There was a registered manager at this 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.

At our last inspection in August 2017 we found breaches of legal requirements and the service was issued two warning notices and placed in special measures. The service did not have robust information about people who used the service and their medical backgrounds and needs. Risks assessments were not robust and were unclear as to how the risks identified were mitigated. Information about how people’s medications were managed were not recorded in a person centred way. In addition, care plans were not personalised and did not contain information about people’s histories or personal preferences. Care plans had inconsistent identifying information within them about people’s names. The service was not monitoring training needs for care staff and staff supervision was not taking place. The registered manager did not maintain an accurate, complete or contemporaneous record in respect of each service user within care plans, within their quality audits or their support of care workers. Recruitment was not always safe as the provider did not always obtain references for new employees.

At this inspection, we found that some improvements had been made and the service is no longer in special measures, however we still found that not all regulations were met. We found the provider was in breach of three regulations of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. You can see what actions we have asked the provider to take at the end of the full version of this report.

The service was not always safe. Risk assessments were still not robust and did not contain information for support workers to follow to manage risks.

Management continued to lack insight and understanding on how to develop thorough risk assessments and what it meant to manage risk and prevent harm.

Care plans lacked detail about people’s preferences and how to support people in a personalised way.

People and their relatives told us they felt safe and support workers knew what to do in an emergency situation.

People had regular and consistent support workers that were punctual.

Recruitment practices were safe and references and checks were obtained by the provider.

All staff had received mandatory training and refresher training had been arranged.

Staff supervision and appraisals were taking place.

People and their relatives told us support workers were caring and positive relationships had been formed.

The service had a complaints procedure and people knew how to make a complaint.

Team meetings were taking place and the provider was carrying out quality assurance practices.

There was a registered manager at the service at the time of our inspection. 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 found the provider was in breach of five regulations of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. You can see what actions we have asked the provider to take at the end of the full version of this report. 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 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.

The service was not safe. The service did not have robust information about people who used the service and their medical backgrounds and needs. Risks assessments were not robust and were unclear as to how the risks identified were mitigated. Information about how people’s medications were managed were not recorded in a person centred way.

Care plans were not personalised and did not contain information about people’s histories or personal preferences. Care plans had inconsistent identifying information within them about people’s names. In addition, information about how people’s medications were managed were not recorded in a person centred way. All of the care plans contained the same information about medicines for each person which meant that the information in care plans was not personalised and did not account for any risks in relation to people’s medicines.

The service was failing to monitor the training needs for care staff and staff supervision was not taking place. In addition, recruitment was not always safe, for example we found that the provider did not always obtain references for new employees.

There were not effective systems and processes in place at the service to assess, monitor and improve the quality and safety of the care provided by the provider. Documentation contained errors, for example information about members of staff were not always correct. There were no quality assurance systems in place and management systems at the service did not ensure that risks were appropriately managed.

Care plans were stored in the same folder as staff member documentation. Folders were labelled with the name of the respective member of staff, and contained their confidential information. At the back of each folder, care plans were filed. This meant that confidential information could be compromised and care plans could not be accessed conveniently.

The provider did not demonstrate an understanding of the Care Quality Commission and the way in which we inspect, which resulted in a lack of oversight of the service as well as a lack of knowledge in relation to documents such as care plans and risk assessments.

Relatives of people who used the service told us they thought their relative was safe with care workers and that they were treated with dignity and respect.

The service had a complaints policy in place. The registered manager told us they had not received any complaints since registering the service.