27 October 2014
During an inspection looking at part of the service
The provider sent us an action plan to explain how they were going to address the concerns. We re-visited the service on 27 October 2014 to check if the provider had made any of the required improvements to the issues we had previously highlighted.
The following summary is based on a review of progress on the action plans sent to us in response to our last inspection, our observations during our visit and our discussions with people who used the service and the staff who supported them. We also looked at people's care records, management records and other documentation.
Two adult social care inspectors and a pharmacy inspector carried out this inspection. At the time of our inspection the home was without a registered manager. We spoke with a senior staff member about this and they told us they had submitted an application to become the registered manager for the service. Our records confirmed this.
Below is a summary which describes what we found. If you want to see the evidence supporting the summary please read the full report.
Is the service safe?
During this inspection our pharmacist inspector looked at how information in medication administration records and care notes for people living in the service supported the safe handling of their medicines. We found that medicine administration records did not accurately reflect what medicines people had received. For example not all medicines could be accounted for numerically and so we could not be assured people's medicines were being administered as intended by their prescribers.
People were at risk of infection because there was a lack of arrangements and guidance in place to prevent cross infection.
Is the service effective?
Risk assessments were in place for some areas of care such as skin care and moving and handling however we found other areas such as diet and nutrition had not been risk assessed
Is the service caring?
We saw that people's choices and preferences about how they wanted to be cared for were not respected or supported by staff.
Is the service responsive?
We saw where needed there people had access to external healthcare professionals . Records of visits were maintained to show
any actions agreed. However, we found although the service liaised with other agencies and services to make sure people received care in a joined up way, where changes to care needs had been identified, staff had not acted promptly to in order to respond to the changes needed.
Is the service well led?
There was no registered manager in post at the time of our inspection.
The provider had some quality assurance processes in place. Audits did not detail how and when changes would be made to ensure continuous improvement.