Archived: Leahurst

Updated 12 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We undertook an unannounced comprehensive inspection of Leahurst. This inspection was carried out to check whether improvements to meet legal requirements by the provider after our inspection on 30 April 2015 had been made.

The inspection was undertaken by one adult social care manager and one social care inspector.

Before our inspection we reviewed the information we held about the home, this included the provider’s action plan, which set out the action they would take to meet legal requirements.

At the visit to the home we spoke with seven people who used the service, the registered provider, four staff on duty on the three visit days, looked at the care records for six people, medication and care plan audits and staff training and supervision records.

Updated 12 January 2016

We carried out an unannounced comprehensive inspection on 12 November, 1 and 2 December 2015.

We completed an unannounced comprehensive inspection of this service on 30 April 2015 and found the provider was failing to meet legal requirements. Specifically the provider had breached Regulations with regard to person centred care, dignity and privacy, cleanliness and infection control, governence and staffing of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued the provider with two warning notices and three requirements stating that they must take action.

We undertook a further unannounced comprehensive inspection on 12 November, 1 and 2 December 2015, as part of our on-going enforcement activity and to confirm that they now met legal requirements but we found continued breaches of legal requirements. We found the service had improved in relation to cleanliness and a person had been employed to complete cleaning duties. However, it had not made sufficient improvements in; person-centred care, good governance and supporting staff and remained in breach of these regulations.

At our visit of 1 December we found two staff on duty to support the seventeen people who live at the home. One staff member had to cook meals for people as the cook had rung in sick.

Following our last inspection and as a result of visits by Halton council contract monitoring team had suspended placements. Other local health care providers had also taken the view that people were at risk from unsafe care and treatment and had suspended placements.

Leahurst provides acommodation for 26 adults with mental health needs. There are two buildings, the main building which has a separately accessed first floor three bedroom flat at the rear and the lodge a three bedroom detached property which is in front of the main building. The flat and the lodge have their own kitchen, bathroom and living areas.

There was a registered manager in place at the home, however they had been suspended from duty since 15 October 2015 . A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered provider visited the home on a daily basis but we found there were no robust management structures in place at the home. Audits of medicines and care plans were limited in depth and were not effective at identifying issues.

There were 17 people living at the home on the day of our visit. We spoke with people living at Leahurst and they said they were “OK “ and felt supported by staff.

The main fire safety risk assessment had been updated and there were Personal Evacuation Emergency Plans (PEEPs) in place so that staff would know the best way to help people evacuate the building in the event of an emergency. Work requested to be carried out at the home by the fire safety officer was proceeding.

During this inspection we found the registered provider failed to mitigate risk to the health and wellbeing of people as risk assessments were not robust. They did not identify the risk or the control measures to reduce and manage the risk. We found risk assessments for people living at the home had not been been improved since our last visit and two people were putting themselves in a vulnerable position in the community and this was not risk assessed and measures were not in place to support these people.

Care plans did not provide staff with sufficient detail on strategies to follow to provide people with the care they needed.

People were not protected against the risks of receiving care that was inappropriate or unsafe because care was not planned and delivered to meet their individual needs or ensure their safety and welfare.

Staff training was underdeveloped with large gaps in the training of staff particularly around the Mental Capacity Act and Deprivation of Liberty Safeguards and mental health needs.

We also found the registered provider had failed to display the most recent rating by the Commission of the service providers overall performance. Discussion was held with the registered provider and he stated he was unaware that the rating must be displayed.

This is a breach of Regulation 20A: Requirement as to display of performance assessments of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC.

The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

The service will 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 we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

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