Archived: Qumran Rest Home

Updated 9 June 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 checked 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 on 11 and 12 April 2017. The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed the information we held about the home. This included past reports and notifications. A notification is information about important events which the service is required to send us by law.

We spoke with seven people who lived at Qumran. We spoke with three care staff, the trainee manager, registered manager from Eschol House, the finance manager and the provider.

We spoke with a visiting healthcare professional, and one relative. We looked around the premises and observed care practices.

We looked at care documentation for five people living at Qumran, medicines records for six people, five staff files, training records and other records relating to the management of the service.

Updated 9 June 2017

This unannounced comprehensive inspection took place on 11 and 12 April 2017. The last inspection took place on 22 March 2016 when we found no breaches of the regulations.

Qumran is a care home which offers care and support for up to ten predominantly older people. At the time of the inspection there were ten people living at the service. Some of these people were living with dementia. Bedrooms were arranged over two floors. There was a communal lounge and a dining area on the ground floor. A stair lift assisted people to access the first floor.

The service did not have a registration requirement to have a registered manager in post because when the service was registered the provider was actively managing the service. The management arrangements at Qumran had subsequently changed and the service had appointed a trainee manager, supported by a registered manager of another service in the group, Eshcol House. At the last inspection in March 2016 the provider had assured us that an application for a registered manager would be sent to the Care Quality Commission following the inspection. This action had not been taken.

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.

The service was not meeting the requirements of the Mental Capacity Act 2005, including the associated Deprivation of Liberty Safeguards. Where it was recorded that people living at the service did not have capacity to make their own decisions, it was not evidenced how staff came to this conclusion. We found some assessments had not been appropriately recorded. The manager told us they were aware they may be restricting some people but had not made the necessary applications for an authorisation.

Care plans were not consistently updated and did not provide staff with guidance and direction to enable them to meet people's needs effectively. People living at the service and where appropriate, their families, were not routinely involved in the development of care plans and subsequent reviews.

Risks were not consistently identified, assessed and monitored for any changes. We found falls risk assessments were contradictory to information held in mobility sections of one person’s care plan. The management of the service had carried out their own audit on risk assessments and acknowledged there was room for improvement in the consistency and quality of risk assessments.

We found the fire safety regulations highlighted in a Fire Safety inspection in August 2016 had not been met. The service had been visited by an external fire risk assessment company and a report issued. The recommendations from this report had not been fully implemented.

People and relatives had recently been asked for their views and experiences of living at the service. Views were generally positive although there was a consistent complaint about the consistency and quality of food served. People’s comments included “Food wise, there is good and there’s bad. I’ve brought it up at our monthly meetings. Nothing changes.

People living at the service did not have access to sufficient meaningful activities to occupy their time. People told us there were not regular activities offered at the service. One person commented, “It does get boring at times. You can go into the garden, weather permitting, or watch TV or read but there’s not a lot going on.” We saw the service had an advertised activity of the day which showed a different activity against each day. Staff told us this was ‘a work in progress’ and we noted the advertised activity on the first day of inspection did not take place.

We looked at how medicines were managed and administered. We found it was possible to establish if people had received their medicines as prescribed. Regular medicines audits were being carried out. However, we saw errors in transcribing were made when handwriting medicines administration records from one format to another and instances when these had not been appropriately double signed by staff to help ensure any errors would be identified and addressed.

Qumran did not have appropriate systems in place to assess, monitor and improve the quality of the service.

Staff were clear on how to report any concerns they may have regarding the safeguarding of people at the service. Staff had recently been supported with supervision and appraisals. Training had been provided in key areas such as moving and handling. Fire warden training had been identified as being required. There was a training schedule in place to ensure staff were kept up to date.

Staffing levels at the service were adequate to provide safe care. Staff reported feeling supported by management. Staff meetings were held regularly. These allowed staff to air any concerns or suggestions they had regarding the running of the service.

We walked around the service which was comfortable and personalised to reflect people's individual tastes. People were treated with kindness, compassion and respect.

We identified breaches of the regulations. You can see what action we have told the provider to take at the back of the full version of the report.