Archived: Laburnum House Limited

Updated 13 May 2015

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 provider is 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 inspection took place on 3 and 4 December 2014 and was unannounced. The inspection team consisted of two adult social care inspectors.

Before this inspection we reviewed previous inspection reports and notifications that we had received from the service. As this inspection was undertaken at short notice we were not able to request a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We spoke with a staff member from the local commissioning team and also spoke with the local authority quality monitoring officer. We used the information we had to help plan our inspection.

During this inspection we spoke with five people who used the service, one relative, three care staff, the cook, the deputy manager and a person acting on behalf of the provider who told us they were the project manager. We did this to gain their views of the service provided. We looked around all areas of the home, looked at how staff cared for and supported people, looked at three people’s care records, nine medicine records, staff training records and records about the management of the home.

Updated 13 May 2015

This unannounced inspection took place over two days on 3 and 4 December 2014. There were 11 people using the service at the time of this inspection.

Laburnum House provides personal care and accommodation for up to 13 people who are recovering from a mental illness. The home is a detached property with a small garden area and is situated in a residential area close to Bury town centre.

The home had a manager registered with the Care Quality Commission (CQC) who was not present on the day of the inspection. A registered manager is a person who has registered with 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 and associated regulations about how the service is run.

At our previous inspection on 24 September 2014 the provider was not meeting the requirements of the law. This was in relation to the safety and suitability of the building, supporting workers and assessing and monitoring the quality of the service provided. Following the inspection we required the provider to send us an action plan to tell us what improvements they were going to make. The provider failed to send us an action plan.

During this inspection we looked to see what improvements had been made and if the Warning Notice, served on the 28 October 2014 following the September 2014 inspection, had been met. We also looked at other areas of the service to check the provider was meeting the regulations.

The Warning Notice was served because the provider had failed to have regard to the professional and expert advice given to them in respect of fire safety within the home. During this inspection we found the Warning Notice had been complied with.

We found that although the staff understood what care and support people required there were not enough staff available at all times to ensure people’s needs were met.

People were not protected against the risk of unsafe or inappropriate care because care records were not updated, did not reflect people’s needs and failed to show how identified risks were to be managed.

We found that people were not always cared for in a dignified way. Some people looked unkempt and were wearing creased ill-fitting clothing.

There was no encouragement or support for people to undertake activities either inside or outside of the home. No activities were provided to help promote people’s well- being.

Inspection of the training plan showed that staff did not receive the necessary training to enable them to have the skills to do their job properly and care for people safely and effectively.

We found the management of medicines was unsafe and did not protect people who used the service. The provider had failed to keep medicines secure. This meant people were able to access the unsecured medicines and this placed their health and safety at risk of harm.

We found that food stocks were minimal and people were not provided with a choice of suitable and nutritious food to ensure their health and well-being were protected. People we spoke with told us they felt they had enough to eat but they would sometimes like something different.

We asked to see the recruitment files of staff who had been employed by the provider since our last inspection of 24 September 2014. We were told that one new staff member had been employed but that the recruitment file could not be found. Records of recruitment must be available to show that people employed by the provider are of good character, fit to do their job and are suitable to work with vulnerable people.

We looked around all areas of the home and found several areas of the home were in a poor state of repair. Carpets were stained, furniture was damaged, wallpaper was ripped, there were problems with some aspects of the plumbing and the home was cold. This affected the well-being of the people who used the service.

The staff we spoke with were not able to demonstrate their understanding of the requirements of the Deprivation of Liberty Safeguards (DoLS). They were also not aware of the procedure to follow in the event of a person being deprived of their liberty. This could result in people being deprived of their liberty in an unlawful way.

There were no systems in place to assess and monitor the quality of the service provided to ensure people received safe and effective care.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what enforcement action we have taken at the back of the full version of this report.

During this inspection we found that people were supported by kind and patient staff. The people we spoke with told us they liked the staff. They told us the staff were understanding and they felt safe with them.

The staff we spoke with were able to demonstrate their understanding of the whistle blowing procedures and they knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred.