You are here

Archived: Pettsgrove Care Home Good

The provider of this service changed - see old profile

The provider of this service changed - see new profile

Reports


Inspection carried out on 12 April 2016

During a routine inspection

This inspection took place on 12 April 2016 and was unannounced. At the last inspection on 16 July 2015 we had found that while some improvements had been made from the inspection of December 2014, there were still breaches of regulations. These were in respect of safe management of people’s finances, insufficient arrangements to deal with emergencies to reduce risks to people, not having regard to treating people with dignity and respect at all times and not operating effective systems and processes to make sure they assessed and monitored their service.

Pettsgrove Care Home is a care home that provides care, support and accommodation for up to six people with learning disabilities. At the time of our inspection there were five people living in the home.

We took enforcement action following the inspection on 16 July 2015 and imposed conditions on the provider's registration regarding concerns we found about the management of people’s finances. We also served a warning notice in respect of a breach for not operating effective systems to monitor the quality of the service.

We carried out this inspection on 12 April 2016 to check what progress had been made in respect of addressing the breaches identified at the July 2015 inspection and also carried out a comprehensive ratings inspection.

At this inspection the home was supporting five people. There was a manager but no registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The current director had submitted an application for registration as a registered manager by CQC..

We found considerable improvements had been made in each key question. People’s relatives felt the service was safe and that staff treated people well. The conditions we had imposed and the warning notice we had served had been complied with. There were appropriate records of people’s finances including their spending. Staff carried out daily and weekly checks of people’s finances to reduce the risk of financial abuse. Risks to people were identified and monitored.

There were sufficient staff to meet the needs of people and the service had conducted appropriate recruitment checks before staff started work.

People had been involved in the planning of their care. We also saw that their relatives were involved as appropriate. Support plans and risk assessments provided clear information and guidance for staff on how to support people. This included guidance about meeting people’s nutritional needs.

Staff received adequate training and support to carry out their roles. They asked people for their consent before they provided care and demonstrated a clear understanding of the Mental Capacity Act 2005(MCA) and the Deprivation of Liberty Safeguards (DoLS).

Staff respected people and involved them in decisions about their care. People’s independence was promoted and supported.

Staff told us there had been improvements at the home following our July 2015 inspection. Audits had been carried out to identify any improvements that were needed. Staff felt confident they were heading in the right direction. The director of the service felt the service had recruited the right staff and management team to move the service forward.

Inspection carried out on 16 July 2015

During a routine inspection

We carried out an unannounced comprehensive inspection of this service on 11 and 12 December 2014, at which we found one breach of legal requirements. This was because the provider did not ensure people’s care records were accurate and up to date; had not taken action to ensure the complaints procedure was accessible to people using the service and did not have effective systems for monitoring the quality of care.

After the comprehensive inspection, the registered provider sent us an action plan telling us how they would meet legal requirements and recommendations. We undertook a focused inspection on the 19 June 2015 to check that they had followed their plan and to confirm that they now met legal requirements. We found the provider had started to address the shortfalls, but still needed to demonstrate the service was well-led.

We undertook another comprehensive inspection on16 July 2015 to check that the provider had fully implemented their action plan, to confirm that they met legal requirements and because of safeguarding concerns that had been reported to us which are subject to an on-going investigation.

You can read the report from our last comprehensive and focussed inspection, by selecting the 'all reports' link for ‘Pettsgrove Care Home’ on our website at www.cqc.org.uk’.

Pettsgrove Care Home provides accommodation for up to six people with learning disabilities. At the time of our visit there were four people using the service.

The service did not 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 and associated Regulations about how the service is run.

At this inspection, one of the service directors was managing the service pending the appointment of a registered manager.

Whilst there were systems in place to review the quality of the service these were not sufficient to ensure high quality care was provided and that risks to people’s safety and welfare were mitigated. These quality checks had failed to identify shortfalls we saw at this inspection.

People were not protected from the risk of financial abuse because the provider did not ensure there were safeguards in place to protect people’s financial interests. CQC is considering the appropriate regulatory response to resolve the problems we found in respect of this regulation.

There were no sufficient arrangements to deal with emergencies to reduce risks to people. There were no assessments about people’s support needs in respect of evacuation. Similarly, staff were unsure about how to safely support people to leave the building in an emergency.

Although people were supported to eat regular meals, their choices for food were not always supported.

People were supported to access external health and social care professionals. There was evidence that people were referred to specialist services when required.

There were suitable arrangements for the recording, storage, administration and disposal of medicines.

We identified four breaches of the relevant regulations in respect of safeguarding people, safe care and treatment, dignity and respect, and good governance.

Inspection carried out on 19 June 2015

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 11 and 12 December 2014, at which we found one breach of legal requirements. This is because the provider did not have effective systems for monitoring the quality of care.

After the comprehensive inspection, the registered provider sent us an action plan telling us how they would meet legal requirements and recommendations by 31 July 2015. We undertook a focused inspection on the 19 June 2015 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Pettsgrove Care Home’ on our website at www.cqc.org.uk’.

Pettsgrove Care Home provides accommodation for up to six people with learning disabilities. At the time of our visit there were four people using the service.

The provider did not have a registered manager. The service had submitted an application to the Care Quality Commission for the registration of a new manager. The director of the service was providing general management support pending the appointment of a new 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 and associated Regulations about how the service is run.

At this inspection, the service director was managing the service pending the appointment of a registered manager.

At our focused inspection on the 19 June 2015, we found that the provider had followed their action plan and legal requirements had been met.

We found that the provider had taken action to ensure people’s care records were accurate and up to date. The provider had introduced a weekly and monthly audit system that looked at areas of care, including people’s care records. Relevant charts, including weight, food and fluid charts were completed and up to date.

The provider had taken action to ensure the complaints procedure was accessible to people using the service and their relatives or representatives. A copy of the procedure had been sent to relatives. The service had also put in place a pictorial version of the complaints procedure.

We found that the provider had started to address the shortfalls, but still needed more time to demonstrate the service was well-led. We found that action had been taken to ensure the service was well-led. The service had employed a new manager to oversee the implementation of their improvement plan. A new audit system had also been introduced.

Inspection carried out on 11 and 12 December 2014

During a routine inspection

This was an unannounced inspection carried out on 11 and 12 December 2014. Pettsgrove Care Home provides accommodation for a maximum of six people with learning disabilities. At the time of our visit there were five people using the service. At our last inspection in January 2014 the service had met all the regulations we looked at.

The service did not 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 and associated Regulations about how the service is run.

At this inspection, the service director was managing the service pending the appointment of a

registered manager.

The complaints procedure was not accessible to people using the service and their relatives or representatives. We have given a recommendation about this.

The service worked closely with funding local authorities and other healthcare providers, including the local hospitals and general practitioners. People had access to healthcare professionals when required, such as their GP, hospital consultants, a psychiatrist and a dietician.

People were supported to make choices about their care. Care plans included information about people’s likes and dislikes and a description of daily routines and personal preferences. However, in some cases the care plan folders we reviewed lacked details and there were some inconsistencies in the contents. The discrepancy in the written information may have exposed people to the risk of being given the wrong care and treatment. We have also given a recommendation about this.

Care plans explained how people wished staff to help them meet their needs, encourage their independence, respect their lifestyle and help them meet their goals. However, the provider had not always responded to people’s needs in a timely manner. In one example, one person had not been referred to an appropriate healthcare professional until the intervention of their social worker. In other examples, people had not received health action plans in a timely manner.

The provider did not have an effective quality assurance system. The system did not systematically ensure that staff were able to provide feedback to their managers, which meant their knowledge and experience was not being properly taken into account.

The director and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). This helped to ensure that people’s rights in relation to this were properly recognised, respected and promoted.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

We found that the registered person had not protected people against the risks of inappropriate or unsafe care by means of the effective operation of systems to assess and monitor the quality of services provided. This was in breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection carried out on 21 January 2014

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service because people using the service had complex needs, which meant they were not able to tell us their experiences.

A relative told us that people were well cared for, pointing to the competence of staff and management.

People experienced care and support that met their needs. Care and support was centred on people as individuals and considered all aspects of their individual circumstances.

People who used the service were protected from the risk of abuse. The provider had ensured that staff understood aspects of safeguarding processes that were relevant to them.

People were protected against the risks associated with medicines. Appropriate arrangements were in place in relation to the recording of medicines. The home had a clear audit trail of ordering, receipt and administration.

The provider operated effective recruitment procedures, which ensured enough qualified, skilled and experienced staff were recruited to meet people's needs.

Staff were supported to deliver care and support safely and to an appropriate standard.

Inspection carried out on 4 October 2012

During an inspection in response to concerns

People using the service had limited verbal communication skills. Therefore we undertook observations to understand how people were supported by staff and the type of service they received.

We observed people being treated with dignity and respect, staff ensured doors were closed and people were covered appropriately when supported with their personal care.

Care plans were provided in a user friendly and person centred format, people were involved in a regular review process. People benefited from varied activities, which were provided regularly. People were able to choose if they wanted to part take in activities and alternatives were provided if required.

People were protected from abuse and staff demonstrated good understanding of reporting and dealing with allegations of abuse.

Staff had varied opportunities to gain more skills and periodic training opportunities were offered, this ensured people were supported by skilled and qualified workforce.

Regular checks and surveys about the service ensured people were able to contribute to their treatment or care and improvements were implemented were shortfalls were reported.