Archived: Blossom Care Home

Updated 23 May 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 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.

The inspection took place on 13 and 16 March 2017 and was unannounced. The inspection was carried out by two adult social care inspectors on the first day and an adult social care inspector on the second day.

Prior to the inspection we reviewed the information we held about the home. This included information from the local authority contracts, commissioning and safeguarding teams as well as information we received through statutory notifications.

We used a number of different methods to help us understand the experiences of people who lived in the home, including observations and speaking with people. We spoke with five people who lived at the home, four care and support staff, the cook, a member of domestic staff and the interim manager.

We looked at eight people’s care records, five staff files and training data, as well as records relating to the management of the service. We looked around the building and saw people’s bedrooms, bathrooms and other communal areas.

Updated 23 May 2017

The inspection of Blossom Care Home took place on 13 and 16 March 2017 and was unannounced. The location had been previously inspected in November 2016 and was found to be ‘Inadequate’, with multiple breaches of regulations relating to person centred care, safe care and treatment, governance, staffing, consent, premises and equipment and meeting nutritional and hydration needs. In addition, we found a breach of the Care Quality Commission (Registration) Regulations 2009 because the registered provider had failed to notify the Care Quality Commission of specific incidents. The service was placed into special measures.

During this inspection, we checked to see whether improvements had been made. We found continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment, premises and equipment, staffing, governance, consent and person centred care. We also identified a breach of the regulation relating to dignity and respect.

Blossom Care Home is a residential home, registered to provide care for up to a maximum of 20 people. There were 12 people living at the home at the time of our inspection. On the first day of our inspection, there was no management presence at the home. At 9am we were told the interim manager was due to arrive. However, at 10.15am we were told the interim manager was absent from work due to sickness and the deputy manager was on leave. On the second day of our inspection, the interim manager had returned to work.

The service had a registered manager at the time of our inspection. However, the registered manager had been absent from work due to maternity leave since March 2016. The interim manager told us the registered manager was not returning to Blossom Care Home.

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 registered provider was not present at the home on a day to day basis and had engaged an agent, who had employed an interim manager. The interim manager had been in post since November 2016.

The staff we spoke with understood the signs to look for which may indicate potential abuse and staff were clear about who they would report concerns to.

We found some risks to people had not been assessed and care plans were not sufficient to ensure everyone’s needs could be met safely. Some care records did not contain information which would enable staff to safely assist people to move. A person who was at risk of choking did not have an associated risk assessment in order to provide staff with the information they would require to safely assist the person. These concerns were highlighted at the last inspection.

The premises were not safe and an enforcement notice had been issued by the West Yorkshire Fire and Rescue Authority. Some work, which was required to meet the requirements of the enforcement notice, had not been completed. Some windows on the first floor were open wide, well beyond the recommended limit, and this presented a risk to people. Other building safety works were outstanding such as gas safety and lift maintenance works.

Staff had been safely recruited but we found the deployment of staff was not always effective.

Recording of the administration of medicines was inconsistent and not always in line with the registered provider’s own policy.

There was a lack of staff support, supervision and training. There was no training matrix in place to provide an overall view of training. Some staff had not received training in areas such as safeguarding, the Mental Capacity Act 2005, fire safety and basic first aid. Evidence of staff supervision was lacking and staff told us they had not received regular one to one supervision in order to monitor their performance and development needs.

People were not supported to have maximum choice and control of their lives and staff did not support people in the least restrictive way possible. The registered provider was not acting in accordance with the Mental Capacity Act 2005 (MCA). Some people had decisions made on their behalf without the principles of the MCA being followed. Some people were being deprived of their liberty without authorisation or the necessary safeguards in place.

People received support to access additional healthcare such as GPs and district nurses.

Although people told us they felt staff were caring, our observations were that staff did not always treat people with dignity and respect. We observed some staff providing care and support without communicating with people.

People’s human rights were not always upheld. We had identified this as a concern at the last inspection in November 2016 and had discussions with the registered provider and their agent, and they had failed to make improvements.

Some care plans contained personalised information to enable staff to provide effective care. However, some people’s care plans required updating and were lacking essential information, such as risk assessments and specific plans of care. This had been highlighted as a concern at the last inspection.

We found there to be a lack of meaningful activities and two people told us told us they were bored.

People were able to make their own choices, such as what to eat, what to wear, where to sit and what time to get up and go to bed.

We found continued inadequate management of Blossom Care Home. There was a lack of management oversight. For example, regular safety checks had not been completed, some audits had not been completed, there was a lack of staff support, the premises were unsafe, risks were not assessed, appropriate records were not kept and emergency plans were not in place.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. Services in special measures are kept under review and further enforcement action may be taken as appropriate.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.