Background to this inspection
Updated
12 September 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This unannounced inspection took place on 20 August 2017 and was undertaken by two inspectors.
Before our inspection, we reviewed the information we held about the service. We looked at Crystal Homes’ previous inspection reports and other information we held including statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law. We used all of this information to plan our inspection.
During the inspection, we looked around the home and observed the way staff interacted with people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
During the inspection, we spoke with two people using the service. The registered manager was not available on the day of our inspection. We spoke with one member of care staff and the manager who was in charge of the day to day operations of the service.
We reviewed two people’s care plans and their medicine administration records. We looked at three staff members' records relating to recruitment, training, induction, duty rosters, supervisions and appraisals. We also looked at records related to the management of the service that included quality assurance audits, safeguarding reports, accident and incident records, complaints and policies and procedures.
We checked feedback the service had received from people using the service, their relatives, health and social care professionals and visitors.
After the inspection, we received feedback from two health and social care professional and the local authority who commissioned the service. We spoke with a relative of people using the service who gave us feedback about their experience of the home. We also spoke with two members of the care staff.
Updated
12 September 2017
We carried out this unannounced comprehensive inspection on 20 August 2017. At our last comprehensive inspection of 28 February 2017 and 6 March 2017 we found the registered manager and provider were in breach of regulations related to safe care and treatment, good governance, fit and proper persons employed and notification of incidents.
After the inspection, the Care Quality Commission took enforcement action (issued a notice of proposal to cancel the provider’s registration) due to the high risk posed to people’s health and well-being. The provider sent us an action plan and told us what they had done to meet legal requirements in relation to the breaches identified. We carried out this inspection to check that they had followed their plan and to confirm that they now met legal requirements. At this inspection, we found that the issues identified in our previous inspection were resolved and the provider now met all the relevant requirements.
Crystal Homes provides accommodation and personal care for up to four people with mental health needs. At the time of the inspection, three people were using the service.
The service had a registered manager at the time of the inspection. 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.
The registered manager had overall responsibility for the service, but a manager conducted the day to day management of the service. The manager had started an application process for registration with the CQC.
People were safe at the service. Staff understood their responsibility to identify and report abuse to keep people safe. Staff identified risks to people’s well-being and had sufficient guidance on how to provide safe care.
The registered manager deployed sufficient numbers of staff to meet people’s needs safely. The provider had appropriate recruitment and selection procedures in place to ensure that they only employed staff suitable to provide safe care.
The premises were safe for people using the service. Fire doors had the appropriate seals, intumescent strips, and suitable door closing mechanisms. The provider carried out repairs and maintenance of the service in a timely manner.
Staff were trained and skilled to undertake their roles effectively. Staff understood people’s needs and the support they required. People received care provided by staff who received regular supervisions, annual appraisal and training.
Staff delivered people’s care in accordance with the requirements of the Mental Capacity Act 2005. People consented to care and treatment.
People received food that met their nutrition and hydration needs. Staff encouraged people to eat healthy foods and to maintain a balanced diet. People had access to healthcare services when needed to maintain their health and well-being.
People were treated with respect, kindness and compassion. Staff maintained people’s dignity and privacy. People were supported to develop skills for independent living and to take part in activities they liked.
People received care that was responsive to their individualised needs. People had their needs identified and assessed. Support plans provided guidance to staff about how to deliver care.
People gave their views about the service and the provider considered their feedback. People knew how to make a complaint and were confident that they concerns would be addressed.
People using the service and staff were happy about the management of the service. Staff understood their responsibilities and were valued at the service. The manager maintained a high presence at the service and was available to talk to people and to offer guidance to staff.
Quality assurance systems were effective to identify shortfalls at the service. The provider made improvements in a timely manner and submitted notifications to the CQC as required.
People benefited from a person centred culture that focused on their individual needs. The provider had established positive working relationships with external agencies and worked closely with other health and social care professionals.