Archived: Hope Residential Care

We undertook this focussed inspection on 08 and 11 December 2015 to check that the provider had followed their plan and to confirm that they now met legal requirements. We also looked at concerns we received prior to the focussed inspection about on call management arrangements to support staff members working alone, staffing levels and the financial viability of the service. This report covers our findings in relation to those requirements and the concerns brought to our attention. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hope Residential Care on our website at www.cqc.org.uk.

Hope Residential Care Home is situated on Waterloo Road in the residential area of south shore Blackpool. Off street parking is available for visitors. The home is registered to provide accommodation for a maximum of twelve people. At the time of our inspection visit there were six people who lived there. Bedrooms were located on the ground and first floor. Communal space comprised of a lounge and a dining room on the ground floor.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers 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. The registered provider was not present during our inspection.

During the comprehensive inspection of this service on 16 and 21 July 2015 we found recruitment procedures were unsafe. This was because the registered provider had employed people before appropriate checks had been completed. These checks were required to ensure staff working at the home were safe to work with vulnerable people. This was a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

During this inspection the recruitment records of one person employed since our inspection on 16 and 21 July 2015 were not available. This meant we were unable to identify appropriate checks had been made to ensure the person was safe to work with vulnerable people.

We also found whilst reviewing a selection of employment records that one member of staff had been employed since 2013 without a Disclosure and Barring Service check (DBS).

This was a continued breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

During the comprehensive inspection of this service on 16 and 21 July 2015 we found the registered provider had not notified the Care Quality Commission (CQC) without delay of the death of a person who lived at the home, allegation of abuse and an application to deprive a person who lived at the home of their liberty. This was a breach of Regulations 16 and 18 of the Care Quality Commission (Registration) Regulations 2009.

During this inspection we found the registered provider had not fulfilled their regulatory responsibilities. This was because they had not submitted a notification to CQC about an injury suffered by a person who lived at the home. The injury had been sustained since our last inspection.

We also found the registered provider had not submitted a notification to CQC about the financial viability of the service and staffing situation which was likely to threaten to prevent, the service provider’s ability to continue to carry on the service safely.

This was a continued breach of Regulation18 of the Care Quality Commission (Registration) Regulations 2009.

Through our observation and discussions with people who lived at the home and staff we noted that a number of systems to keep people safe had failed. There were numerous breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which meant the service was not safe or well-led. You can see what action we told the provider to take at the back of the full version of the report.

We found suitable on call management arrangements were not in place to support staff working alone in the home. We were told by staff members about occasions when they had been unable to contact the registered provider when they required assistance to support people in their care. This meant people did not always receive the care and support they required when they needed it.

We found the induction training for new staff wasn’t structured and organised. One staff member told us they had not received any induction training and had been left to work on their own for periods of time during their first few weeks of employment. This meant people who lived at the home had been supported by a person who wasn’t suitably trained and experienced to support them.

We found one staff member responsible for the administration of medicines had received no medication training or been assessed to ensure they were competent to support people with their medicines prior to being left alone to administer medicines. This meant people who lived at the home had been potentially placed at risk from unsafe management of their medicines.

We found the environment had not been well maintained and lacked investment. We saw carpets which were frayed and a potential tripping hazard to people who lived at the home.

We found furnishings in some rooms were in a poor state of repair. The cupboard door to a vanity unit in one room was broken and hanging off its hinges.

Maintenance records including gas, fire and electrical installation certificates were not available for inspection. This meant records were not available for the regulated activity and we were unable to confirm these facilities had been serviced and were safe for use.

We found the home did not have a working tumble dryer and people’s wet clothing was dried on radiators around the home. This created an unpleasant smell of dampness and was undignified for people who lived at the home.

Two staff members told us they had been instructed by the registered provider to leave the heating turned off until 4pm. We were told people were provided with additional clothing and blankets to keep them warm when the heating was turned off.

We found arrangements for meal provision were poor. Staff told us about occasions when they had purchased bread and milk with their own money because of the lack of funds available to them from the registered provider. This was as recent as the week before the inspection.

We found the falls risk assessment for one person identified as being at risk of falling had not been recently reviewed. There was no information recorded to identify how staff lone working would manage the person in the event of them falling.

We found appropriate procedures had not been followed to record safeguarding concerns, accidents and incidents and take necessary action as required. This meant people were not always safe.

We identified during the inspection the registered provider had not taken all reasonable steps to ensure the financial viability of the service. This was evident in the lack of investment in the environment and funds not being available for food provisions.

After the inspection took place the registered provider made the decision to close the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them, people visiting the home and from looking at records. We also spoke with Blackpool council's contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. People living at the home told us they were happy and well looked after. We found staff had received appropriate training and good supervisory and peer support arrangements were in place. This confirmed people were having their health and welfare needs met by competent staff. Systems were in place to make sure the manager and her staff learnt from events such as accidents and incidents, complaints and concerns raised about the service.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support. People's health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found the care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person. People spoken with said their care plans were up to date and reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. People we spoke with were happy with the care being provided. One person said, 'I love it here. The staff are all lovely people and look after us all really well. I have had my hair done today they keep me tidy and well presented. We have lots of activities to keep us entertained. I have a good sense of humour and the staff are always making me laugh'. Another person said, "I am very happy and have no complaints about anything. I would recommend this place to anyone'. A visiting relative told us he looked around a number of homes before deciding on this home. The relative said, 'I was very impressed with what I saw and heard. Mum moved in for a short stay and didn't want to go home because she loved the place. It's a small friendly home with very caring staff'.

Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

We found people completed a range of activities in and outside the service regularly. These included various games, access to the computer and going out for walks. People we spoke with said they were kept busy and entertained and they were happy. People knew how to make a complaint if they were unhappy. They all told us they had no reason to complain. We found people had access to healthcare professionals. People received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.

'I am really well looked after here. The staff couldn't do any better in my opinion. They are always available if you need them. They have been very supportive with my care'.

'The meals are excellent. Ample portions and you can always ask for more if you want. We are always provided with a choice of meal. I fancied a chop the other day so they went to the shops and got me one'.

'They wait on me hand and foot. I am completely pampered. I have no complaints about anything whatsoever'.

'This is a lovely care home. The staff are so friendly and always there if you need them. We have a very friendly and relaxed atmosphere and the place is always clean and smells fresh'.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.