Background to this inspection
Updated
30 November 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.The inspection was carried out by the lead adult social care inspector for the service and a fellow adult social care inspector on 12 January and 19 January 2015.
Prior to this inspection visit, we received a number of safeguarding alerts from the district nursing team and local authority. We also had discussions with a family member of a person living at the home regarding what they believed was poor quality care. The issues they raised related to a lack of support when being help to eat, poor mouth care, and inadequate support with personal care.
During the inspection visit we spoke with a range of people about the service. This included Registered Manager, five staff members, the service provider, six people who used the service and two visiting family members. We also spoke with a visiting district nurse and a social worker. Prior to this inspection we contacted the local authority in order to ascertain if there were any issues from their perspective. They had major concerns regarding the nature and number of safeguarding alerts they had received. We spent time looking at records, which included the care records of seven people, five of the staff training records and a number of management and audit records relating to the running of the home.
Updated
30 November 2015
This unannounced inspection took place on 12 and 19 January 2015. The home is registered for a maximum of 33 people. It is a purpose built property on two levels and is located close to the city centre of Preston. Accommodation is provided in single rooms with en suite toilet facilities. There are 2 lounge areas and a dining room.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report. Whilst we were giving feedback on our inspection to the service provider and registered manager, the service provider announced that he had made the decision to close the care home as a result of reviewing the service’s financial position, and he believed that a planned closure of the home was in the best interests of the people living at the home. The service provider proceeded to give 30 days notice to all the people living at the home. After liaison with the local authority and clinical commissioning group, all the people living at the home moved to alternative accommodation. The home closed on 16 February 2015.
Peoples view’s about the service they received were mixed. While some people were very happy, others were not. In addition, our observations did not always match the positive descriptions that some of the people living at the home had given us.
The systems and procedures operated at the home were not designed to enable people to live their lives in the way they chose, so they could be as independent as possible. The care and support offered to people at the home was not personalised and had the potential to put people’s dignity at risk, as well as increasing the risk of people developing health and social care problems. The care provided was task orientated and did not take account of people’s assessed needs, preferences and choices.
The service did not consistently respect and involve people in the care they received. For example, all the care plans viewed did not show the person’s choices and personal preferences. The care plans did not involve the person or their relative when they were written and their views were not reflected in the care plans. People told us they had no input into the menus or activities and we saw that the choice of meals was limited.
Staff members did not always follow the Mental Capacity Act (2005) for people who lacked capacity to make decisions. People’s mental capacity was not properly assessed and there was no information available in the service for the staff that helped them support a person with fluctuating capacity. We saw inconsistent approaches from staff with some staff explaining to people before they undertook a care process, other staff failed to give the person any information about the care and support they were about to deliver.
Staff were not provided with effective support, induction, supervision, appraisal and training. The service did not have a system to manage and report accidents and incidents. When action plans were needed to monitor people's safety these were not produced. The service did not have any robust quality assurance and, where appropriate, governance systems in place.
There were little or no accountability systems in operation within the home. If care tasks or records were not completed, no action was taken by the Registered Manager or service provider to address the issues and ask people for a clear explanation as to why they had not undertaken their responsibilities properly. There was a registered manager in place at the time 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 last inspected this service on 19 August 2014 and the home was compliant with the regulations we checked during the inspection.