Archived: Scarletts

Updated 22 November 2019

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.

This unannounced focused inspection took place on 19 and 21 March 2018. The inspection was prompted in part by information of concern that we received in February and March 2018 from various sources including the local authority and whistle blowers. This prompted the Commission to carry out a further inspection at Scarletts. We also inspected to check the progress being made towards improving the service following our comprehensive inspection carried out in June 2017 and the subsequent focused inspections carried out in September 2017 and December 2017 and January 2018. These inspections found the provider was not meeting legal requirements.

Prior to the inspection, we reviewed information we had received about the service such as notifications. This is information about important events, which the provider is required to send us by law. We also looked at information sent to us and minutes from meetings that had been attended by the provider and professionals involved with Scarletts. We spoke with members of Essex County Council safeguarding and quality teams about their visits to the service.

We inspected the service against two of the five questions we ask about services: is the service safe? and is the service well led? This is because the service was not meeting some legal requirements and we needed to check that people were safe. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Three inspectors undertook the inspection. During the inspection, we spoke to four people who used the service. Some people could not tell us what they thought about the service as they were unable to communicate with us verbally therefore we spent time observing interactions between people and the staff who were supporting them. We also observed the care and support provided to people and the interaction between staff and people throughout our inspection.

We spoke with the provider’s representative, the manager, the supporting manager, the compliance standards officer, two external consultants, ten staff members and two kitchen staff members.

To help us assess how people’s care and support needs were being met, we reviewed the records of 13 people who used the service including risk assessments and monitoring charts. We also looked at systems for assessing and monitoring the quality and safety of the service.

Updated 22 November 2019

This was an unannounced and focused inspection of Scarletts residential home carried out on 19 and 21 March 2018.

Scarletts is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and we looked at both during this inspection.

Scarletts accommodates and provides personal care for up to 50 older people. At the time of this inspection, there were 18 people accommodated, who were vulnerable due to their age and frailty, and in some cases had specific and complex needs, including varying levels of dementia related needs and end of life.

The service had no registered manager in post. However, a new manager who intended to apply for registration had started work at the service on the day of our inspection. 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.

We carried out an unannounced comprehensive inspection of Scarletts in June 2017 and we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was poor leadership, management and provider oversight of the service resulting in people receiving poor care and risks to people’s health and welfare not being adequately protected. We took immediate enforcement action to restrict admissions and placed conditions on the provider’s registration to improve the assessment of risk, leadership, staffing and oversight.

The service was given an overall judgement rating of ‘inadequate’ and is therefore in special measures.

We continued to keep Scarletts under review and following information from whistle-blowers and the local authority, we carried out unannounced, focused inspections in September 2017 and December 2017 and met with the provider’s representatives in January 2018. These inspections focused on the areas of ‘Safe’ and ‘Well led’. We also checked the provider’s progress in addressing the breaches of Regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 identified at our comprehensive inspection in June 2017.

We found continued and widespread concerns with the governance, leadership and provider oversight of the service resulting in a failure to address recurring areas of risk to people and to learn lessons when things had gone wrong. There was a failure to drive and sustain improvement.

The local authority safeguarding and quality monitoring teams continued to monitor the service through regular visits and support, mitigating the risk to people using the service.

You can read the reports from our previous inspections, by selecting the 'all reports' link for Scarletts on our website at www.cqc.org.uk

This inspection focused on the areas of ‘Safe’ and ‘Well-led’. We found that sufficient improvement had not been made since our last inspection and the provider was continuing to fail to meet the requirements of the regulations, commonly referred to as The Fundamental Standards of Quality and Safety.

Risk management processes continue to be ineffective and the provider continued to demonstrate a lack of understanding of the risks affecting people living at Scarletts. Staff were not equipped with the right information and skills so that people receive safe and appropriate care. People were not protected from the unsafe management of medicines.

Robust and sustainable auditing and monitoring systems were not in place to ensure that the quality and safety of care was consistently assessed, monitored and improved. Failures in the service continued to be widespread and demonstrated the provider's inability to make and sustain improvements. We continue to have concerns about the provider’s oversight of the service, inconsistent governance and leadership.

Some of the conditions that were placed on the provider’s registration to try to encourage improvement after our inspection in June 2017 have not been met.

The Commission is currently considering its enforcement powers. This includes taking action in line with our enforcement procedures to begin the process of cancelling the provider's registration.