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Archived: The Old Rectory Inadequate

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Inadequate

Updated 21 September 2016

The Old Rectory is a care home that provides accommodation and personal care for up to 60 older people including care and support for people living with a diagnosed dementia. There were 41 people in the service when we inspected on 14 and 18 July 2016. This was an unannounced inspection.

The registered manager was on leave at the time of inspection and an interim manager was in post. 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.

There was not a culture in the service which promoted a holistic approach to people’s care to ensure all physical, mental and emotional needs were being met. Robust and sustainable audit and monitoring systems were not in place to ensure that the quality of care was consistently assessed, monitored and improved

Quality assurance systems had failed to identify the issues we identified during our inspection. The provider had failed to demonstrate that there were sufficient financial or practical resources to drive forward improvements and for these to be sustained.

There were not enough staff on duty to meet people’s care and support needs. People told us that they often had to wait for assistance when using their call bell. There were a high incidence of falls in the service and we were concerned that at times this was due to a lack of staff being available.

People were at risk due to poor monitoring of environmental factors and essential maintenance not taking place when needed. Risks to people injuring themselves or others were not always appropriately managed.

People’s medicines were not being managed effectively to protect them from the associated risks of not receiving prescribed medicines. Staff had not been proactive in seeking professional advice when there were concerns relating to peoples medicines.

The provider had not ensured the service was being run in a manner that promoted a caring and respectful culture. Although staff were attentive and caring in their interactions with people, they were not supporting people in a consistent and planned way.

Staff had not always taken appropriate action to protect people who had conditions which may put them at risk. They did not always respond appropriately and in a timely manner to all of people’s needs.

Care plans were lacking in information to assist staff in meeting the specific needs of people living with dementia. There was little detail to guide staff how to support people with the things that interest them, details of social activities they enjoyed or details of their life history and people of importance to them.

Staff were aware of their responsibilities with regard to safeguarding people from abuse and knew how to report concerns. However, they did not recognise or understand the wider aspects of safeguarding people from risk as identified in this report.

Training and development was not sufficient in some areas to show that people’s healthcare conditions were fully understood by staff. Records showed that where there had been cause for concern regarding the conduct of staff there had been little or no action taken.

Staff demonstrated a lack of knowledge regarding the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.) However, staff understood the importance of gaining people’s consent and we observed that they asked people's permission before they provided any support or care.

Relatives had been updated regarding recent changes and asked for their opinion. However, there had not been the same opportunity for the people living at service.

During this inspection we identified a number of breaches of the Health and Social Care Act 2008

(Regulated Activities) Regulations 2014. You can see what action we told the prov

Inspection areas

Safe

Inadequate

Updated 21 September 2016

The service was not safe.

There were not enough staff on duty or deployed effectively to meet people’s care and support needs.

Risks to people injuring themselves or others were not appropriately managed.

There was poor monitoring of the environment and essential maintenance to ensure risks to people were minimised.

People’s medicines were not being managed effectively.

Effective

Inadequate

Updated 21 September 2016

The service was not effective.

Staff training and development was not sufficient and did not always reflect the needs of people being cared for.

People were supported to maintain access to appropriate services which ensured they received ongoing healthcare support.

Caring

Requires improvement

Updated 21 September 2016

The service was not consistently caring.

The provider had not ensured the service was being run in a manner that promoted a caring and respectful culture.

Although staff were attentive and caring in their interactions with people, the routines of the service did not support them to do this in a consistent way.

Responsive

Inadequate

Updated 21 September 2016

The service was not responsive.

Care plans were mainly task focused and not personalised to individual’s needs. Information was inconsistent and did not support staff to understand fully what people needed.

Staff did not always respond appropriately and in a timely manner to people’s needs

Well-led

Inadequate

Updated 21 September 2016

The service was not well led.

Robust audit and monitoring systems were not in place to ensure that the quality of care was consistently assessed, monitored and improved

The culture in the service did not reflect the provider’s own aims and objectives. There was a lack of focus to ensure staff worked together to achieve positive outcomes.

The provider had failed to demonstrate sufficient support to the interim manager to ensure improvements could be made.