1 October 2019
During a routine inspection
Cana Gardens is a care home providing personal care for up to eight people with a learning disability and/or autistic spectrum disorder. At the time of the inspection there were two people using the service.
Why we inspected
This was a planned inspection based on the previous rating. We have used the previous ratings to inform our planning and decisions about the rating of this inspection.
People’s experience of using this service and what we found
We found insufficient improvement had been made to move the service out of special measures.
The provider continued to have ineffective systems to ensure people consistently received good quality outcomes. The management team appointed to oversee the day to day management of the service did not have the resources or authority to bring about improvement. This meant there were no plans to improve the environment, nor was there a planned programme to develop, support and manage care staff through on-going training and assessment of their competence.
People had their medicines safely when they needed them, however staff had not updated their training in medicine management. People’s safety was promoted, staff were aware of how to minimise risk to people’s by following their individual risk assessments and care plans. People were supported by sufficient numbers of staff.
Staff had a system of cleaning in place, using products which were stored securely. However, a malodour remained in a specific area of the service, which could only be addressed through maintenance and refurbishment, there were no plans at the time of the inspection to make the necessary improvement.
Improvement was needed to ensure referrals were made to appropriate services, where people required support with individual needs, which affected their day to day lives. Staff did refer people to health care services, where they had concerns for their physical health and well-being.
Opportunities were available for people to take part in grocery shopping, and their nutritional and dietary needs were met. However, the outcomes for people did not fully reflect the principles and values of Registering the Right Support for people for the following reasons, people’s goals and aspirations were not sought, and therefore plans to support people to achieve and develop new skills within the service were not in place.
People’s capacity to make informed decisions was assessed, and people were supported in the least restrictive way possible, which was reflected in people’s records and kept under review by independent organisations.
People were supported by staff who knew them well, and people and family members we spoke with were positive about the staff and the care and support provided.
Rating at last inspection
The last rating for this service was requires improvement (published 29 April 2019), where two breaches of the regulations were found. The service remains in special measures, as the rating of the key question is the service well-led, continues to be rated as inadequate.
Services in special measure 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 and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to be 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.
For adult social care services, the maximum time for being in special measures will usually be more that 12 months. If the service has demonstrated improvements when we inspect, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Enforcement
We have identified breaches in relation to the provider’s oversight and governance of the service, and the environmental maintenance of some areas within Cana Gardens Residential Home.
Please see the action we have told the provider to take at the end of this report.