Background to this inspection
Updated
12 January 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by three inspectors. Two inspectors visited the home and one inspector reviewed evidence and made phone calls offsite.
Service and service type
Everley Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received about the service since the last inspection. We received feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.
During the inspection
We spoke with three relatives about their experience of the care provided. We spoke with the provider, registered manager and two staff. We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at numerous different documents. However, some evidence we requested was not provided. We spoke with external professionals and the local authority to ensure people were safe.
Updated
12 January 2021
About the service
Everley Residential Home is a residential care home providing personal care and accommodation to people aged 65 and over who may also be living with dementia or physical disabilities. The care home is registered to provide support to 16 people in one adapted building, at the time of inspection 10 people lived at the home.
People’s experience of using this service and what we found
Care and treatment was not provided in a safe way. People were at risk of dehydration and this had not been addressed by the registered manager or provider. People had lost weight, and this had not been escalated to relevant professionals.
People were not protected from potential harm and abuse. People had been subject to abuse and this had not been escalated and investigated to prevent further occurrences. Abuse or improper treatment was not always reported, investigated or acted on.
The provider's systems failed to identify that care and treatment was not provided in a safe way. Audits did not identify risks to people, safeguarding concerns and a failure to report incidents. Staff practice was not effectively monitored.
An infection prevention control audit was carried out by CQC during the inspection. It was found the provider was not meeting government guidelines in regard to COVID-19. People had not been isolated in the home on return from hospital increasing the risks of potential COVID-19 spread. Staff and people had not received regular COVID-19 tests.
Relatives had not been informed when things had gone wrong or their loved ones had been subject to harm or abuse. The provider and registered manager failed to act in an open and transparent way when things went wrong.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (06 August 2020). The service remains rated inadequate. This service has been rated inadequate for the last two consecutive inspections. The provider was asked to complete an action plan after the last inspection to show what they would do and by when to improve, but they failed to submit this. At this inspection improvement had not been made and the provider was still in breach of regulations.
This service has been in Special Measures since 06 August 2020. During this inspection the provider was not able to demonstrate that improvements have been made. The service remains in Special Measures.
Why we inspected
We received concerns in relation to the overall management of the home, people’s health needs and people’s weights. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained as inadequate. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Everley Residential Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment, safeguarding, governance, the registered managers ability to carry out the regulated activity, infection control and the environment, a failure to notify and a failure in duty of candour at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special Measures
The overall rating for this service is ‘inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.