Archived: Lilycross Care Centre

Updated 2 October 2015

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.

We carried out an unannounced inspection on the 28 July 2015 and then undertook a second announced visit on the 3 August 2015. The first day of the inspection was carried out by an adult social care inspection manager, two adult social care inspectors, a pharmacist inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The announced visit on the second day was undertaken by two adult social care inspectors and a pharmacist inspector.

Before the inspection we reviewed all the information we held about the home including any notifications. Because there had been a variety of issues surrounding the home the local authorities who fund placements there [Halton and St Helens] had a support plan in operation. This had been in operation since April 2014. The CQC had been involved in this process and had been attending regular professionals meetings in order to monitor the situation in accordance with its regulatory responsibilities.

During our inspection we saw how the people who lived in the home were provided with care. We spoke with a total of 11 people living there, four visiting family members and approximately 17 staff members including the deputy manager [some staff members spoke to more that one member of the inspection team]. The people living in the home and their family members were able to tell us what they thought about the home and the staff members working there.

We used the Short Observational Framework for Inspection (SOFI) on both Lily and Bluebell suites during the lunchtime period. SOFI is a way of observing care to help us understand the experience of people who could not talk to us.

We looked around the home as well as checking records. We looked at care plans and a variety of other documents including policies and procedures and audit materials.

Updated 2 October 2015

The inspection was unannounced and took place on the 28 July 2015. An arranged visit to complete the inspection was then undertaken on the 3 August 2015.

The last inspection took place on the 21 and 30 January 2015 when Lilycross Care Centre was rated as an inadequate service. Following this inspection we issued the registered provider with a warning notice and four requirement actions. These were in relation to good governance, person centred care and staffing. The manager present during the inspection in January left the home in May and a new manager was appointed.

The new manager sent us an action plan explaining how the warning notice and requirement actions would be met and by when.

During this inspection we found that some issues had still not been addressed and further more serious concerns were identified.

The home is required to have 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. Although at the time of our inspection visit the home did not have a registered manager in post the new manager had applied for registration and their application was being processed by the Care quality Commission.

Lilycross Care Centre is a purpose built home offering people personal care with nursing for up to 60 people. The home is located close to Widnes and St Helens and is close to the local bus route. At the time of our previous inspection the care home had three units which the provider called suites, Lily, the general nursing care suite on the ground floor, Rose, the nursing dementia care suite on the first floor and Bluebell, the residential dementia care suite on the second floor. At this inspection only two suites were open, Rose unit on the first floor was closed and the people living there had moved upstairs into Bluebell suite which now provided nursing dementia care. Lily on the ground floor still provided general nursing care.

All bedrooms are en-suite with several rooms also having shower facilities. On the first day of our inspection there were 16 people living in Lily suite, two of whom were in hospital and 14 in Bluebell suite.

During this inspection we have identified a number of serious concerns relating to how the service was managed.

We found that the provider still had a large number of bank and agency staff members covering shifts, particularly at night. The potential consequence of this was that the bank staff working there may not know the care needs of the people they were caring for.

We found that there were issues with person centred care, consent, safe care and treatment, safeguarding, nutritional needs, good governance and staffing.

These were breaches of Regulations, 9, 10, 11, 12, 13, 14,17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Medicines were not safely managed which placed people’s health at risk.

People were not being adequately safeguarded from harm.

Care plans did not reflect people’s needs and the people living in the home were not receiving care that met their individual needs.

There were inadequate systems and processes in the home to ensure that the service provided was safe, effective, caring, responsive or well led.

The provider has been unable to demonstrate the skills, knowledge or ability to make the urgent changes that were required to make the service safe.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures would usually be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, would be inspected again within six months. In this instance however the CQC used its urgent powers to apply to the Magistrates Court on 11 August 2015 and received a court order to cancel the provider’s registration to carry out the regulated activities at Lilycross Care Centre.

The provider had 28 days to appeal against this order to the First Tier Tribunal [Care Standards] under section 30 of the Health and Social Care Act 2008.  The provider did not appeal and as a result the home's registration has now been cancelled.