Background to this inspection
Updated
16 March 2022
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team was made up one inspector.
Service and service type
Accommodation with Assistants at Hands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we reviewed the information, we held about the service, including notifications we had received. Notifications are changes, events or incidents the provider is legally required to tell us about within required timescales. We sought feedback from the local authority. We used this information to plan the inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spent time with and spoke with four people living at the service, two relatives, two members of staff and the registered manager. To help us assess and understand how people's care needs were being met. We requested key records relating to peoples care needs and the day to day running of the service. These were not made available to us as requested during the site visit. To date we have not received these records.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with four health care professionals, a representative from Plymouth City Council's quality assurance and improvement team (QAIT) and safeguarding team and two relatives.
Updated
16 March 2022
About the service
Accommodation with Assistants at Hand is a residential care home providing personal care for to up to 11 people in one adapted building. At the time of our inspection there were 6 people using the service. The registered manager and provider are the same person.
People’s experience of using this service and what we found
People did not have care plans which meant risks associated with people’s care had not been identified and could not be managed safely. Medicines management was not based on current best practice which exposed people to a significant risk of harm and/ or not receiving their medicines as prescribed. Some medicines were not stored safely.
People were not always protected from the risk of avoidable harm because the risks associated with people’s care were not assessed or managed. The environment and the premises were unsafe and as a result we made an alert to the fire service.
Safeguarding systems and processes were not followed. The registered manager (who was also the registered provider) did not always report and investigate safeguarding concerns. As a result of this inspection we made a safeguarding referral to the Local Authority to ensure one person was safely protected from harm.
The providers oversight and governance of the service was inadequate, Systems were either not in place or not operated effectively. Serious failings in relation to safety and quality had not been identified or addressed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 13 November 2020 and this is the first inspection.
Why we inspected
The services first inspection was brought forward because we received concerns in relation to people’s safety and the management and leadership within the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We wrote to the provider following our inspection asking for an action plan on how they would keep people safe. The provider responded, however we were not fully assured that appropriate action had been/ would be taken to mitigate the risks significant risks we identified.
We have found evidence that the provider needs to make improvement. Please see the safe, and well-led sections of this full report.
Enforcement
We are mindful of the impact of the 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 monitor the service and will take further action if needed.
We have identified three breaches in relation to safety and the quality of the service.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will continue to work with the local authority to ensure people’s safety. The provider has taken the decision to de register this service.