Archived: Upshire Residential Home

The provider has sent action plans detailing plans to ensure improvements were made. However, despite the action plans, the minor improvements made were insufficient to ensure the service was compliant with the regulations.

During our inspection on 17 and 18 October 2013, we found there had been some minor improvements. However, the ongoing non-compliance with a range of regulations had a significant effect on the people who lived at Upshire. Furthermore, we had received information which raised concerns about the management of medicines at the service. The service did not have suitable arrangements in place for the management, administration and recording of medicines.

As a result of this inspection we issued the provider with five warning notices requiring them to make improvements with consent to care and treatment, treating people with respect, involving them in their care and ensuring their welfare. Furthermore, warning notices were issued requiring the provider to ensure that there were suitable arrangements in place for the management of medicines and assessing and monitoring the quality of service. We required the provider to be compliant by 31 December 2013.

The local authorities who sponsored the people living at Upshire decided to find other accommodation for the people who lived there and they had all moved out by January 09 2014.

When we carried out our inspection on the 13 January 2014, there was no one living at Upshire. This meant that we were unable to assess whether there was improvement with the way that some of the regulated activities were carried out. However, we were able to inspect the premises and take into consideration audits and other documents to ensure that the provider had been assessing monitoring the quality of service, whilst people were there.

We found some minor improvements in the environment, however, we still found that the environment was dirty. Furthermore, some of the upstairs fire doors could not be opened, the heating was inefficient and the building was cold, as was the hot water.

We looked at a number of audits and risk assessments. We found these to be inaccurate as they did not reflect our findings during the inspection.

As we had told the provider about these issues before, and as we still found that regulation had not been met, we sent the provider a notice on 15 July 2013 requiring them to meet the relevant parts of the regulation by 30 August 2013.

We visited the service on 11 September 2013 and inspected against the regulation. We found that there had been some limited improvements but that the provider had not complied with the notice and was still not meeting the regulation.

We did not speak with people using the service at this inspection about the provider's quality monitoring systems.

We will be taking further inspections of the service along with considering further actions in line with our enforcement procedures and powers.

At our inspection of 16 May 2013 we found that there had been some minor improvements but that there were still areas of concern.

There were examples of times when people were not involved in decisions that affected both their care and well being. Although some redecoration had taken place, people had not been consulted about what colour they would like their bedrooms painted. There was a lack of meaningful activities for the people who lived there. One person told us, 'I am bored here.'

We looked at five care plans, saw assessments that were inaccurate and plans which did not reflect the care and support that was being given to people.

Suitable arrangements were not in place to ensure that people were safeguarded against abuse.

The home generally was visibly very dirty and dusty. There were inadequate processes in place and insufficient staffing levels to ensure that cleaning could be done thoroughly.

The staffing levels were not adequate to ensure that people's needs were consistently met. Staff did not receive effective support to carry out their roles.

There was a lack of effective audits in place to identify areas of the service provided that were in need of improvement.

At our inspection on 16 May 2013 we found that there was no improvement. In addition, the home was dirty and had no infection control procedures in place and was also very short of staff.

We issued a warning notice on 15 July 2013 requiring the provider to be compliant with assessing and monitoring the quality of service.

We carried out another inspection on 11 September 2013 to check compliance against the warning notice and although there had been some minor progress, there was continuing non-compliance.

During our inspection on 17 and 18 October 2013, we found there had been some minor improvements. However, the ongoing non-compliance with a range of regulations had a significant effect on the people who lived at Upshire.

We had received information which raised concerns about the management of medicines at the service. The service did not have suitable arrangements in place for the management, administration and recording of medicines.

We found several examples of situations in which people's needs were not being met. People and their relatives were not involved in planning their own care. Most relatives were not involved in regular reviews of their family member's care.

People's individual needs were not reflected in their care plans and risks were not assessed appropriately. People's access to shopping, recreation and activities in the local community was limited.

Staff had safeguarding training but a limited knowledge of safeguarding procedures. They did not have adequate supervision to support them to carry out their role effectively or opportunities to discuss their own career development.

The manager did not have an effective system of quality management in place. The views of people and their relatives were not adequately sought or recorded and were not reflected in the running of the service. The service was not monitored regularly to assess quality.