Archived: Annette's Care Limited

Updated 30 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was completed by two inspectors from the adult social care inspection team.

Service and service type:

Annette’s Care is a residential care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Annette’s Care is located in a city location.

The care service was not aware and had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced.

What we did when preparing for and carrying out this inspection:

Prior to the inspection we reviewed information we held about the service, such as feedback we had received from health and social care professionals and provider notifications. A notification is information about important events such as incidents, which the provider is required by law to send us. We reviewed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection, we spoke with four people who used the service. Some people living at Annette’s Care had limited verbal communication, and it was therefore limited in what they could tell us about their care and the service they received. We observed the care in the communal areas.

We spoke with the deputy manager and three members of staff. We reviewed a range of records. This included four people's care records such as support plans, medicines records and accident and incident reports. We also looked at three staff files. We looked at recruitment records, supervision notes and training information shown to us. A range of records were also reviewed relating to the running of the service including, policies and procedures and audits.

Prior to the inspection we contacted a mental health nurse.

Following the inspection, we spoke to the local authority team and two professionals.

Updated 30 April 2019

About the service:

Annette’s Care is a residential care home that was providing accommodation and is registered to provide personal care for up to 4 people with a primary need of Learning Disability. However, at the time of the inspection the care home was also supporting people whose primary need were mental health issues. Some people also had additional learning difficulties and physical disabilities. The care home is located on one site with four individual bedrooms. On the day of the inspection there were three people living at the service and one person on respite.

People’s experience of using this service:

• People who had lived in the service for many years mainly said they were happy.

• Risks in relation to people’s care and lifestyle were not assessed, understood and managed in a way that kept them safe. Some practices in relation to risk did not protect people’s human rights.

• People did not live in an environment that was well-maintained or promoted their dignity.

• People’s rights in relation to their capacity had not been fully understood and respected. Correct processes had not been followed when people lacked capacity to make decisions about their care.

• Risks and needs in relation to people’s physical and mental health had not been consistently understood and supported.

• The culture of the service did not respect and promote people’s rights, dignity and independence.

• The organisation of the service was poor. Leadership and auditing of the service had not been robust and had failed to identify the concerns we found in relation to practice, the environment and the culture of the service. This meant that people had continued to receive a service that was not safe, effective, caring or responsive to their needs.

• The service is now judged to be inadequate in keeping people safe, providing effective care, being caring, responsive and being well-led.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The rating at the last inspection was Good (the last report was published July 2017)

Why we inspected: We inspected in line with our inspection methodology. The inspection was prompted due to concerns received from professionals.

Enforcement

Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up:

Following the inspection we spoke to Plymouth City Council about our initial findings and practices we had concerns about. We also contacted Devon and Somerset Fire Service to share our concerns related to fire safety.

The overall rating for this registered provider is 'Inadequate'. This means that it has been placed into 'Special Measures' by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

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.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded. We will have contact with the provider and registered manager following this report being published to discuss how they will make changes to ensure the service improves their rating to at least Good.