Archived: Walnut Villa

Updated 3 September 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was carried out by one adult social care inspector and one inspection manager.

Service and service type: Walnut Villa is a care home. People in care homes receive accommodation and nursing or personal care. 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. The registered manager was also one of the registered providers. 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. The registered manager was not present on the day of our inspection visit.

Notice of inspection: The inspection site visit was unannounced on 3 June 2019. Our inspection visit on 7 June 2019, was announced.

What we did: We reviewed information we held about the service such as previous inspection reports and statutory notifications. A statutory notification is information about important events, which the provider is required to send us by law.

We asked the local authority and Healthwatch for any information they had which would assist our inspection. We used this information as part of our planning. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. Healthwatch is an independent consumer champion, which promotes the views and experiences of people who use health and social care services. The local authority had shared concerns about the management of the home and the safety of people who used the service.

At the inspection visit we spoke with five people who used the service, two care staff, one of the providers and the administrator.

We looked at two care plans and risk assessments. We looked at records relating to the management of medicines and staff training.

Updated 3 September 2019

About the service: Walnut Villa is a residential care home registered to accommodate up to six people. At the time of this inspection the service was providing personal care to six people who have a learning disability.

People’s experience of using this service:

People were not protected from abuse because staff did not have the skills to recognise abuse or know how to safeguard them. Risks to people were not assessed or action taken to mitigate them. The lack of emphasis focused on protecting people from abuse compromised the care they received. There were insufficient staffing levels to ensure people received a safe and effective service. Medicine management was unsafe, and people did not always receive their medicines as prescribed.

Decisions made on people’s behalf were not always in their best interests. People were cared for by staff who did not have the necessary skills and were not supported in their role by the registered manager. People were not supported by staff to prepare and cook their own meals.

The lack of emphasis focused on protecting people from abuse compromised the care they received. People could not be assured they would receive care and support specific to their needs because they were not involved in planning their care. Staff demonstrated a good understanding about promoting people’s right to privacy and dignity, but this was not always put into practice.

People’s lack of involvement in their care assessment did not ensure they received a service that reflected their preferences. People could not be confident their concerns would be listened to or acted on. People were supported by staff to pursue social activities although, some activities were not of people’s choice.

There was no clear management structure, and no one knew who was running the home. There were no effective systems in place to monitor the quality of service provided to people. The provider did not work closely with other agencies to ensure people receive person-centred care.

Hygiene within the home was maintained to a good standard. Where an accident had occurred, action had been taken to avoid it happening again.

Staff assisted people to attend their medical appointments.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support. This should ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. However, people living at Walnut Villa were not supported to achieve the best possible outcomes.

Rating at last inspection: The service was rated Good at the last inspection in April 2016.

Why we inspected: This was a scheduled inspection based on the previous rating.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.'

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Follow up: ongoing monitoring; possibly more about how we will follow up

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