A north London care home has been rated inadequate by the Care Quality Commission (CQC) and will remain in special measures, following an inspection undertaken in October and November.
CQC inspected HAIL - Great North Road, which cares for up to five people with a learning disability, to assess whether improvements had been made.
CQC rated the home, which is run by Haringey Association for Independent Living, inadequate following its previous inspection.
The latest inspection found the service continued to not meet standards people have a right to expect, although there were areas where improvement had been made.
In addition to rating it inadequate overall again, CQC rated the home inadequate for being safe and well-led. CQC rated the home requires improvement for being effective, caring and responsive to people’s needs.
CQC also served a warning notice, requiring the home to improve its management of people’s medicines and to provide safe care.
CQC also required Haringey Association for Independent Living to provide an urgent action plan, detailing what it will do to improve the quality and safety of care it provides to people at the home. CQC is also working with the home’s manager and the local authority to monitor progress.
CQC will inspect the home again in the coming months. If insufficient improvement has been made, CQC will take further action - which could include requiring the home’s closure.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said:
“We previously told Haringey Association for Independent Living where it needed to improve the care it provides to people at HAIL - Great North Road. While there were areas where it responded positively, it is unacceptable that the service’s care continued to be below standards people have a right to expect.
“The service’s management of people’s medicines wasn’t safe because staff didn’t have adequate knowledge in this area, and processes to support safe medicines management were weak. We have issued a warning notice in response to this, meaning the provider of the service has a legal obligation to make improvements.
“We found people lacked enough opportunities to pursue social activities which would improve their quality of life, particularly in the evenings and at weekends. We also found people’s preferences weren’t adequately considered and reflected in the care they received.
“However, there were positive and caring interactions where staff were kind and supportive of people.
“We also found the service had responded effectively to some of the areas we previously highlighted as needing improvement. This includes refurbishment of the premises – which created a safer environment that was more supportive of people’s wellbeing.
“We’ve reported our findings to Haringey Association for Independent Living, so it knows where it must make improvements to ensure people receive better care.
“If our next inspection finds adequate progress hasn’t been made, we won’t hesitate to take further action.”
The inspection found:
- There was a lack of assurance that staff were trained to understand learning disability and people's rights
- One person spent an afternoon and evening in bed with no personal care. Staff did not recognise that this was unacceptable
- Staffing did not always meet people's needs and preferences. Care was sometimes routine and task-centred, rather than person-centred
- There was a lack of evidence of a positive person-centred culture which promoted people's rights and autonomy
- Managerial oversight was ineffective, and although systems were in place to monitor the quality of care provided by the service, its systems had not effectively improved
- There was a lack of formal engagement with people, staff, professionals and relatives
- Recruitment practices were not consistently safe. Some required checks had not been completed before staff worked at the service, however the provider advised that no new staff had been employed since the last inspection and safer recruitment practices would be used in the future
- People sometimes went to bed early and spent the evening alone in their room when it was not clear whether this was their choice. Inspectors found a person had been left in bed with no personal care provided and no evidence of being supported to change position for seven hours. This person was also given their evening meal sitting up in bed when their eating and drinking guidelines stated they should be sitting upright in their wheelchair to eat. There was no explanation why staff could not have supported the person to get out and eat in their wheelchair in the dining area with other people as per their usual routine. This was not safe care.
However:
- There were some positive caring interactions where some staff were kind and supportive to people.