Archived: Help at Home (Connaught House)

People's experience of this service and what we found

The provider did not have established, robust processes in place to ensure people received their medicines safely and as prescribed.

Systems to monitor the running of the service were not always effective in ensuring improvements were embedded into staff working practices and sustained. The service had experienced a significant turnover in staff and management and remained without a registered manager.

People were supported by enough staff to meet their needs. Staff were safely recruited and inducted into the service. Staff were aware of the risks people faced and the actions they needed to take to keep people safe. People were protected from the risk of infections.

Staff undertook training to meet the diverse needs of people living at the service. People were supported to maintain their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation to ensure the provider follows best practice in undertaking mental capacity assessments.

The provider was in the process of reviewing and developing care plans. People were supported to socialise, interact and maintain links with family and friends, where they wished to, to reduce the risk of social isolation.

People were happy living at Connaught House and enjoyed the support and interactions with staff and each other as part of a community. Staff spoke of increased morale and felt positive about the future development of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating and update

The last rating for this service was requires improvement (published 7 October 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. 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 breaches in relation to the safe management and administration of people's medicines and leadership and governance of the service at this inspection. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People's experience of using this service and what we found

Consistent numbers of skilled and knowledgeable staff were not always deployed to keep people safe and meet their needs in a timely manner. Staff did not always stay for the full duration of care calls. The provider was taking action to make improvements. It was not possible to assess the impact of improvements at the time of inspection as these were at a very early stage. Staff were recruited safely.

Medicines were not always administered safely or as prescribed. People had experienced missed medicines due to missed care calls, including time critical medicines. The provider had introduced more robust audits and checks and planned to re-train staff to reduce the risk of further errors.

Quality assurance was undertaken but was fragmented and systems and processes could not demonstrate any improvements made were sustainable. The provider had failed to ensure systems and processes were established and operated effectively at all times to monitor and improve the quality and safety of the service. They had not identified poor leadership and governance within the service or listened to or taken action when staff raised concerns.

Care plans required review to ensure consistent information was recorded in people's risk assessments and associated care records, and information reflected people's current needs.

People and staff spoke positively about the interim management team and the changes they had made to improve the quality of the care and support provided. Staff spoke of improved morale and confidence in raising concerns and making suggestions. The provider had developed an improvement plan and was working towards making the improvements required to ensure people received safe, quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service under the previous provider was Good (published 29 February 2020).

Why we inspected

The inspection was prompted in part due to concerns received around poor leadership and governance, staffing and medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Help at Home (Connaught House) on our website at www.cqc.org.uk.

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 to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing, how medicines were administered and leadership and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.