Background to this inspection
Updated
26 October 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 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.
This inspection took place on 23 and 29 June 2017 and the first day was unannounced.
One inspector carried out the inspection. Prior to the inspection we reviewed the information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law.
During the inspection we met all four people using the service and spoke with them. One person made their views known by the use of hand signs. We case tracked two people’s care records. This meant we reviewed all their associated documents such as care plans, risk assessments, medicine administration records and daily notes. We talked with three staff including a senior staff member, the registered manager and the deputy manager. We looked at three staff personnel files, this included recruitment documents, supervision and training records. We spoke with two visiting health and social care professionals during our visit.
Following our visit we spoke with one person’s relative, a health and social care professional and the commissioning body.
Updated
26 October 2017
This inspection took place on the 23 and 29 June 2017 and the first day was unannounced.
The service had been rated Good following our inspection in December 2014 but there was a breach of the regulations with regard to medicines administration. A focussed inspection was carried out in June 2015 where we found there was a continuing breach with regard to medicines administration. We conducted a further follow up focussed inspection in September 2015 and found that the service had taken steps to address the medicines administration concerns.
There was a registered manager in post. 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 service did not consistently provide hand wash and paper towels in bathrooms, toilets and the kitchen. There were some poor food hygiene practices by staff such as leaving out of date food in the fridge posing a risk that people might eat the food and become ill.
The staff supported people to attend health appointments and were knowledgeable about people’s health support needs. However, they were not always keeping accurate and robust health records.
Some people using the service accessed a variety of activities in the local area with staff support. However activities provision within the service were limited as equipment and facilities for the activities such as the sensory room and the garden both required attention to make them inviting for people to use and enjoy. We made a recommendation that the service look at best practice in activities within the service setting.
Audits and monitoring by the management team took place however due to the above concerns we found that these were not effective and robust. The provider did not have enough oversight of the provision of the service to ensure that people always received safe and quality care.
The registered manager assessed people’s support needs to ensure there was enough staff on duty. Staff received an induction and training to equip them to undertake their role and staff told us they felt well supported by the management team. There were good lines of communication between the management team, staff and people.
People told us they liked staff and other people at the service. We saw caring and respectful interactions by staff that maintained people’s dignity and supported people to make choices in their daily living activities.
People told us that they felt safe at the service and staff had received training to understand their responsibilities to report safeguarding adult concerns appropriately. People had risk assessments and behavioural support plans that identified risks and measures were taken to minimise the risk of harm to people and others.
Medicines were stored and administered in a safe manner.
The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and had applied for authorisations under the Deprivation of Liberty Safeguards (DoLS) appropriately for people living in the service to ensure their liberty were not unduly deprived.
Staff supported people to eat healthily and remain well hydrated.
People had person centred plans that detailed how they wished to be supported by staff. People were asked their views about their care and relatives views were included in the care planning.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014 in regards to safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report.