Archived: Shassab Residential Care Home

Updated 14 July 2017

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.

The inspection took place 27 and 28 March 2017 and the first day was unannounced. This meant the service did not know we were coming.

On the first day of the inspection there was one adult social care inspector and an interpreter who could speak Urdu and other Asian languages. On the second day one adult social care inspector returned to complete the inspection.

Before the inspection we asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR along with other information we held about the service, including statutory notifications received from them.

We contacted Manchester City Council’s contract and commissioning and public health teams for information they held about this service. We received a copy of the most recent infection control report for the home (dated August 2016). Following our site visit, the local authority contracts and commissioning team contacted us regarding serious concerns they had about the service.

During the inspection we looked around the premises. We spoke with three people living at the care home, a visiting family member and three members of staff. We also spoke with the registered manager and the deputy manager. We looked at three people’s care records, four staff recruitment records, three medicine administration records and other documents relating to the management and conduct of the service.

Updated 14 July 2017

The inspection took place on 27 and 28 March 2017. The first day was unannounced which meant the service did not know we were coming. At the previous inspection in March 2016, we had found the service was not meeting the regulations in several areas such as person centred care, safe care and treatment, submission of notifications, safeguarding people from improper treatment and staffing levels and governance. Based on our findings in March 2016 we also took enforcement action relating to the provision of safe care and treatment and governance systems.

Shassab Residential Care Home (Shassab) is a family-run home which caters for people of different ages from the Asian community, and offers support to people with mental health needs and/or learning disabilities. The home can accommodate up to eight people. There are four bedrooms on the ground floor and four on the first floor. At the time of this inspection, there were six people living there. They each had their own bedroom.

There was a manager in post who has been registered with the Care Quality Commission since October 2010. The manager was also the registered provider. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Most of the people living at Shassab and some of the staff did not speak English as a first language. We used an interpreter to help us communicate with them.

We found breaches, some continuing, of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014 in safe care and treatment, staffing, person centred care, safeguarding people from improper treatment, need for consent and governance systems. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

The service did not consistently deploy sufficient staff to help ensure people were kept safe. This issue had been raised at the previous inspection.

Recruitment processes were not safe as the provider did not adequately undertake all pre-employment checks to help ensure staff employed were suitable to work with vulnerable people.

Risk assessments did not adequately detail actions required by staff to mitigate risk nor did they provide further actions to be taken to ensure that the risks were managed. In some people’s care files, we saw risks had been identified but there were no plans in place to manage these risks. This meant that people were not adequately protected from risk of harm.

Medication administration needed to be more robust. Staff did not sign medication records appropriately and the service did not keep a specimen signature list of staff administering medication. We saw medication audits had been undertaken but these had not been done since August 2016 and the audit tool was not effective.

Not everyone living at the care home had a personal emergency evacuation plan in place. Improvements were needed to manage the risk of infection.

There was a lack of leadership and management intervention to help ensure improvements were made. Governance systems in place failed to identify critical aspects of keeping people safe and ensuring that effective care and support was provided.

People told us staff were good at their jobs. We saw that mandatory training had been done previously; this training included health and safety and moving and handling. However the deputy manager told us staff training required refresher training. This meant that people may be at risk of harm because staff did not have the appropriate skills.

The service was not working within the principles of the Mental Capacity Act 2005; this issue had been raised at the last inspection. The registered manager had not made the necessary Deprivation of Liberty referrals to the local authority meaning that people were being unlawfully deprived of their liberty.

Staff told us they treated people with dignity and respect in how they spoke with and cared for them. We found some practices of the service did not demonstrate the hallmarks of a caring organisation.

There was a lack of activities and recreation provided at the home to stimulate the people living there. This was also the case at our last inspection.

Records showed that people had access to a variety of health care professionals such as GPs, opticians and hospitals. This should ensure that people received the right care when required.

People and relatives felt that staff were caring and kind toward their relations and understood their needs.

Care records showed that people or/and relatives had been consulted at the initial stages of the care provision.

People told us the service provided was good and that they were happy living at Shassab. We observed staff worked as a team. People told us the home was managed well and that they could rely on the registered manager to deal with any issues they may have.