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Archived: The Old Rectory Inadequate

The provider of this service changed - see old profile

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Inspection report

Date of Inspection: 9 June 2014
Date of Publication: 5 July 2014
Inspection Report published 05 July 2014 PDF

Overview

Inspection carried out on 9 June 2014

During an inspection in response to concerns

We carried out our inspection in response to information of concern received from the local authority and others about the care and support provided to people who used the service. As part of this inspection we spoke with 12 people who used the service, four Relatives, seven staff and the registered manager. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is the summary of what we found:

Is the service safe?

We did not find that all areas of the service were safe.

We saw that infection control checks were not robust and effective. We found areas of the service that were poorly maintained and unhygienic. A compliance action has been set in relation to this and the provider must tell us how they plan to improve. There was insufficient domestic staff available to keep the service clean and free from the risk of cross infection.

The registered manager had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). There were no DoLS currently in place. Staff had been provided with the training they needed which would ensure that people were only deprived of their liberty when they needed to be so.

The staff team were skilled and experienced. However, we found concerns with regards to the staffing levels on Redwood unit which was designated to provide care and support for people living with an advanced dementia. Staffing levels were not consistently maintained and were at times insufficient to meet people�s needs. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

We found medicines were stored safely for the protection of people who used the service. We were assured that appropriate and effective monitoring arrangements were in place to identify and resolve medication errors promptly.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

During our observations we saw that people on the Redwood unit were bored, and disengaged. We saw that there was little evidence that the service provided activities specifically designed to engage and stimulate people living with a dementia.

The provider had a quality assurance system in place and the records we examined showed that health and safety audits had been carried out. However, due to our concerns found during this inspection, it was not evident that these audits were effective in keeping people safe from the risk of infection and robust enough to ensure that their needs were met by enough qualified staff. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service caring?

Staff supported and interacted with people in a friendly and supportive manner. However, staff were seen to be rushed and stressed, which meant that we could not be assured that the people who used the service received appropriate care and support.

Is it responsive?

Where concerns about an individual's wellbeing had been identified, staff had taken appropriate action that ensured people were provided with the healthcare support they needed. This included seeking support and guidance from care professionals, including dieticians, doctors and community nurses.

We found that activities provided for people living with a dementia were limited and not always appropriate given some people�s complex needs as a result of their living with a dementia.

Is the service well led?

The manager held 'residents' meetings and a weekly surgery where people could speak with them to discuss any concerns they may have about how the service was managed.

We saw there were insufficient numbers of trained staff available on a daily basis to meet people�s needs. Action had been taken by the manager to recruit new staff. However, there was insufficient staff deployed to meet the needs of people living with a dementia on Redwood unit.

Quality audits were not always robust in identifying shortfalls, for example in monitoring the cleanliness of the service. There were insufficient systems in place to control the risk of cross infection.