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Bay View Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 April 2016

The inspection of Bay View took place on 7 July and 29 September 2015. At the previous inspection on 10 December 2014 and 5 February 2015 we identified twelve breaches of regulation. These breaches applied to regulations 9 (twice), 22, 15, 12, 21, 13, 23, 17, 14, 24 and 10 under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Since 1 April 2015 the regulations have changed to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Those breaches of regulation therefore equated to breaches of regulation 9: Person-centred care (twice), 18: Staffing (twice), 15: Premises and equipment, 12: Safe care and treatment (three times), 19: Fit and proper persons employed, 10: Dignity and respect, 14: Meeting nutritional and hydration needs, and 17: Good governance.

Bay View is registered to provide care and accommodation to a maximum of 23 older people who are vulnerable because of their age and illness only. There are 21 single occupancy bedrooms and one shared occupancy bedroom on three floors. There are two lounges and a dining room for people to use. There is a passenger lift to the upper floors. At the time of this visit there were four people living there permanently, but two of these were in hospital.

There was a registered manager in post who had managed the service since it was registered under Quality Care UK Limited in August 2014. 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.

During our July and September 2015 inspection we found that the service was still in breach of regulations 15, 19 and 12. The premises were still unsafe with regard to electrical systems and so people were not safe from the risk of harm from electric shock or fire. The registered manager continued to deploy staff that had not been recruited using a robust recruitment procedure. This meant people were cared for by staff that weren't thoroughly checked according to the criteria of ‘fitness’ to work with vulnerable people. People were supported by staff who did not follow the correct dress codes and who did not follow the correct practices with reference to infection control. This meant people were not fully protected from the risks associated with poor infection control.

We are considering our enforcement powers and will report on this at a later date.

We found there was some improvement in the staff training with staff booked on courses but which they had yet to attend. People’s choices had also improved. We found that the service was not as caring as it could have been. Some improvement had been made with staff consulting people more about their preferences and choices. However, the staff weren’t always ensuring people’s dignity was upheld with regard to their personal care needs.

We found there had been improvements in the responsiveness of staff to meeting people’s needs and this was partly due to only two people using the service. We found that care plans had been reviewed and contained better information for staff to know how best to meet people’s needs. We saw that a limited range of activities was provided for people and that complaints were appropriately handled.

The service had improved its cooperation with other providers and organisations so that people were referred to health care specialists for support in a timelier manner and there was improvement in the area of quality monitoring and assuring service provision. However, the service did not accurately maintain the records it was required to in order to manage the regulated activity.

This was a new breach of regulation 17: good governance, with regard to record keeping. You can see what action we told the registered provider to take at the end of the full version of the report.

The overall rating for this provider is ‘Requires Improvement’. However, at the last inspection we found key areas of inadequate care, which gave the service an overall rating of ‘Inadequate’. At this inspection in July and September 2015 the service had not demonstrated sufficient improvement and one key area remained ‘Inadequate’. Therefore this means that the service has been placed into ‘Special measures’ by CQC. The purpose of special measures is to ensure the service improves its care to people that use the service.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains 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 the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will 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 we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s 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.

Inspection areas

Safe

Inadequate

Updated 11 April 2016

The service was not safe.

People that used the service were not protected from the risks of harm because the provider had not ensured the premises were safe with regard to electrical systems, staff were not safely recruited and safe infection control systems and practices were not in place.

Effective

Requires improvement

Updated 11 April 2016

The service was not effective.

Staff training had improved sufficiently for the service to no longer be in breach of the regulation but there was more training for staff to achieve in order to meet people’s needs and carry out safe working practices.

People’s nutrition was according to their choice but food provision still required improvement because the service still did not supply fresh cooked meals, as there were no ancillary staff employed.

Caring

Requires improvement

Updated 11 April 2016

The service was not caring.

Although there were improvements in the way the service consulted people about their daily preferences and choices, there was still poor adherence to ensuring people privacy was maintained when providing personal care and support.

There were improvements in the way the service consulted people about their daily preferences and choices. However, there remained poor adherence to ensuring people’s privacy was maintained when providing personal care and support.

Responsive

Good

Updated 11 April 2016

The service was responsive.

People received a better quality of care than at our last inspection because there were only two people that used the service and they received more regular support and attention from the staff. People’s care plans had been reviewed and instructed staff on how best to meet their needs. The opportunity for people to engage in activities had improved.

Well-led

Requires improvement

Updated 11 April 2016

People had improved opportunities for their health care needs to be met and there had been improvements in the quality monitoring system in the service, so that previous breaches of regulation were met.

However, we identified a new breach of regulation 17: good governance in respect of the records maintained in the service.