Archived: Keresley Wood Care Centre

Updated 20 May 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by one interim inspection manager, two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

There was no registered manager in post at the home. The service is required to have 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. A new manager had been offered employment and was going through the recruitment process.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from a health care professional, a social care professional and the local authority who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with eight people who lived at the home and seven relatives about their experiences of the care provided. We spoke with the managing director, the manager and 11 staff including, nurses, care staff, agency care staff, the maintenance person and the cook.

We reviewed a range of records about people's care and how the service was managed. This included six people's care plans, nine people’s supplementary records and a range of medicine records to ensure they were reflective of people’s needs. We looked at three staff personnel files in relation to recruitment, training and staff supervision and reviewed a variety of records relating to the management of the service, including quality assurance audits and checks.

Updated 20 May 2020

About the service

Keresley Wood Care Centre is a care home which provides nursing and personal care for up to 47 older people. At the time of our visit 28 people lived at the home. Accommodation is provided in a two-storey adapted building.

People’s experience of using this service and what we found

This is the sixth consecutive inspection where the provider has failed to achieve the minimum expected rating of good.

The provider had failed to take action to meet regulatory requirements and to improve to the service people received. We found there continued to be a lack of effective governance, provider and management oversight at the home. The home did not have a registered manager and the provider had failed to ensure staff had the leadership and management support they needed to fulfil their roles effectively. Quality monitoring systems and process continued to be ineffective. This demonstrated lessons had not been learnt since our last inspection.

People and relatives told us low staffing levels and the increased use of agency staff continued to impact negatively on people’s experiences. This meant people did not receive consistent good quality, safe care. The provider continued to fail to manage and mitigate risks associated with people’s care. However, people told us they felt safe. The management of people’s medicine had improved.

Most staff were recruited safely. Staff received an induction when they started working at the home and completed on-going training. However, the induction for agency staff was not effective and people and relatives did not have confidence in the knowledge and skills of agency staff.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support this practice.

People and relatives spoke fondly of the permanent staff who provided their care and support. Permanent staff understood the needs of the people they supported. People’s privacy was respected. However, some people’s dignity was compromised and their independence was not promoted. People were encouraged to maintain important relationships and had access to a health and social care professional when needed.

People’s care was not always provided in line with their needs and preferences. People’s care plans contained the information staff needed to provide personalised care. However, staff did not always have the time they needed to read people’s care plans. The completion of supplementary records continued to require improvement to demonstrate people had received their care and support safely and as planned. People had opportunities to engage in meaningful activities. Complaints were not well-managed.

Despite our findings, people and relatives told us they were happy with the care provided but were dissatisfied with the way the home was being managed.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 10 May 2019) and there were three breaches of the regulations.

Following our last inspection, a condition was placed on the provider's registration for them to submit weekly reports to us to show actions taken to improve the service. We had not received all of these reports. During this inspection we found some of the weekly reports we had received contained inaccurate information regarding improvements made.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

At this inspection, enough improvement had not been made and the provider continued to be in breach of three regulations. The breaches related to risk management, staffing levels and how the service is managed.

We are mindful of the impact of Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is now ‘Inadequate’ and the service in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.