Archived: Faraday House

Faraday House is a care home for up to three people with a mental illness. At the time of this inspection, one person was using the service.

The service has a registered manager. 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 found one breach of the regulations as the provider did not always notify the Care Quality Commission about incidents or events that affected people using the service.

The provider had arrangements in place to keep people safe. They assessed possible risks to people and gave staff guidance on how to mitigate these.

There were enough staff to meet people’s care and support needs and the provider carried out checks to make sure staff were suitable to work in the service. We have recommended that the provider renews criminal record checks on staff working in the service.

Staff had completed the training they needed to provide care and support to people using the service.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. We saw people were free to move around the service and the local community and there were no restrictions on their liberty.

People had a varied and nutritious diet that met their individual needs and access to the healthcare services they needed. People received the medicines they needed safely.

People received kind, compassionate care by staff who had a good knowledge of them as individuals. The provider and staff involved people in making in decisions about their care. Staff working in the service respected people's dignity and privacy and promoted their independence.

The provider assessed and regularly reviewed people’s care needs and developed plans to meet these.

People told us they knew how to make a complaint about the care and support they received and they trusted the provider to respond appropriately.

The provider had systems in place to monitor quality in the service and make improvements. They had also improved their policies and procedures and the way they recorded the care and support people received in the service.

The last inspection of the service was on 01 December 2015 when we found eight breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found the providers did not manage risks to people using the service, inform the local authority of possible safeguarding incidents and did not always provide enough staff to support people. They did not carry out robust recruitment checks on new staff, had not applied to the local authority for authorisation when they placed restrictions on people and did not ensure staff had the training they needed to support people. The providers also did not involve people in planning and reviewing the care and support they received, did not always manage complaints effectively, did not promote a culture that was person centred and empowering and there was no evidence of the involvement of other professionals in people’s care. We also found the adaptation, design and decoration of the service did not meet people’s individual needs. The provider sent us an action plan on 22 March 2016 detailing how they would address the concerns we raised. At this inspection we found the provider had made improvements in most of the areas where we had concerns.

Faraday House is a care home for three people with mental health needs. The providers and their family lived in the property and shared some facilities with people using the service. When we carried out this inspection, one person was using the service. Since our last inspection, one person moved on to more independent accommodation and a second person passed away after a short illness.

One of the registered providers was also the registered manager. 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 found one breach of the regulations. The providers needed to improve the standard and recording of safety checks carried out in the service to make sure people were supported safely. This included making sure the service met fire safety standards and hot water was delivered at a safe temperature.

The providers had improved standards of monitoring and evaluating quality in the service. However, there was a need to make sure quality monitoring systems were implemented and reviewed consistently to make sure people received the care and support they needed in a safe and appropriate way.

The providers and staff had improved standards of recording and record keeping, although further improvements in records management were needed. Some records were incomplete and others were disorganised which made them difficult to review.

People were supported by staff who were suitable because the providers carried out checks before they started work in the service. There were enough staff to make sure people received the support they needed.

The providers had systems to ensure people would receive their medicines safely and people had the support they needed to access healthcare services.

Staff had completed the training they needed to support people using the service.

The provider had improved the environment to meet the needs of people using the service.

We saw staff interacted with people in a friendly and respectful way. They respected people's choices and privacy and responded promptly to requests for support. The person we spoke with also told us that the providers and staff respected their privacy.

People received care that was focussed on their needs and the provider involved them in reviews of their support plan. Staff knew the contents of care plans and were able to answer our questions about the care and support people needed and how they provided this.

The provider had reviewed their systems for recording and responding to complaints and people told us the providers gave them information about how to make a complaint. The provider also arranged monthly meetings with people using the service to discuss any improvements or changes that were needed.

Following our last inspection in December 2015 we judged the service was Inadequate and we placed it in special measures. At this inspection we found the providers had addressed the concerns we raised with them and had made improvements to the quality of care and support people received. We have judged the service as Requires Improvement and it is no longer in special measures.

Faraday House is a care home for three people with mental health needs. The providers and their family live in the property and share some facilities with people using the service. When we carried out this inspection, three people were using the service. All had lived there for at least a year.

The registered providers, Mr and Mrs Gopal, are also the registered managers. 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 found seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The providers did not identify, assess or mitigate risks to people using the service.

The providers did not inform the local authority of possible safeguarding incidents.

The providers did not always provide enough staff to support people and did not carry out robust recruitment checks on new staff.

The adaptation, design and decoration of the service did not meet people’s individual needs.

The providers had not applied to the local authority for authorisation when they placed restrictions on people, as required by the Deprivation of Liberty Safeguards.

The providers did not ensure staff had the training they needed to support people.

The providers did not involve people in planning and reviewing the care and support they received.

The providers did not always record and manage complaints effectively.

The providers did not promote a culture that was positive, open, person centred and empowering.

There was no evidence of the involvement of other professionals in people’s care and support.

We recommend that the providers obtain up to date guidance on the management of medicines in care homes.

The provider arranged for and supported people to access the healthcare services they needed.

People told us they enjoyed the food provided in the service.

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.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains 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 the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. 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.

We also looked at records kept in the home and saw all parts of the premises.

People's needs were assessed and recorded in their care plans and possible risks to their safety and welfare were assessed, recorded and managed by staff.

The home provided good standards of shared and private accommodation.

There were enough staff working in the home to meet people's assessed care needs.

There was an effective complaints procedure known to people using the service and formal complaints were recorded and fully investigated.

The provider made sure that all records kept in the home were accurate and up to date. The health and social care records of people using the service were stored securely.

We found people were involved in the planning of their care. People received regular reviews and had the opportunity to discuss their care with their main care worker monthly. We found where people wanted additional support the service provided this.

We looked at people's care plans and risk assessments and found these were not always detailed to ensure that effective care was being delivered. We also found where there was a change in a person's health there was not always a care plan or risk assessment put in place to manage the condition.

We found that staff were appropriately trained and were aware of how to protect people from abuse. We found that staff on two occasions had identified where people were possibly being abused and had acted appropriately.

The service completed regular audits of medication and maintenance of equipment to ensure people were protected from risks of harm.