12 October 2017
During a routine inspection
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People did not receive support from sufficient numbers of staff. People told us they felt safe with the staff, however people were not always safeguarded from abuse. Risks to people were not always managed to ensure they were kept safe. People did not always receive their medicine as prescribed and the medicine administration records did not reflect the support people needed.
People did not always receive support from knowledgeable staff with the skills to provide their support. People were not supported in line with the principles of the Mental Capacity Act. People did not always have support to meet their nutritional needs. People were not supported to monitor and maintain their health.
People were not supported by a consistent staff group which meant building caring relationships was difficult. People were not always able to choose for themselves and express their preferences about when their care and support was delivered. People did not always receive support in a way, which protected their dignity and privacy.
People were not supported by staff who understood their needs and preferences. People were not asked about their preferences. People understood how to make a complaint, however people felt their complaints were not listened to.
People, relatives and staff told us they felt unable to raise their concerns with the registered manager. Staff felt unsupported by the registered manager and did not feel they could approach them with their concerns. The quality of the service was not assessed effectively and there was no identification of the concerns we found during the inspection or any action taken to make improvements.
During this inspection we identified nine breaches of the Health and Social Care Act 2008. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
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.
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."