Archived: Bexhill Care Centre Limited

Updated 18 July 2019

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.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Bexhill Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 we reviewed the information we held about the service and service provider. We looked at the action plan provided to CQC following our last inspection and information received from health and social care professionals, the local authority and commissioners of care.

During the inspection

We spoke with 12 people who used the service and one relative. We spoke with 10 members of staff, including the registered manager, nurses, care staff and chef.

We reviewed a range of records. This included five people’s care records, incident and accident records, medicine administration records and four recruitment files. We spoke and corresponded with the provider after the inspection.

Updated 18 July 2019

About the service

Bexhill Care Centre is registered to provide personal and nursing care for up to 41 older people who are living with dementia and/or have physical disabilities. There were 34 people living at the home during the inspection

People’s experience of this service

The provider did not have an effective quality assurance and monitoring system to assess the services provided and ensure people had appropriate care and support. The provider did not have oversight of the service, which meant they had failed to identify areas where improvements were needed, and placed people at risk of harm.

People’s health, safety and well-being were not always protected, because pre-admission assessments had not identified people’s specific needs before they moved into Bexhill Care Centre. The care plans and risk assessments based on the pre-admission assessments therefore had not always reflected people’s needs or provided clear guidance for staff.

There was some guidance for staff to follow to protect people, such as, those at risk of falls. However, from our observations and records staff did not always follow this guidance and people were at risk of falls. Where accidents and incidents had occurred the registered manager or staff had not made referrals to the local authority under current safeguarding procedures. They had not kept CQC informed of these incidents and lessons had not been learnt to prevent re-occurrence.

Medicines were not managed safely. The ordering, checking and storage of medicines had not followed relevant guidelines and people had not consistently received their medicines as prescribed.

There were not enough staff working in the home with the right skills and knowledge to provide personalised care to people, based on their needs, preferences and choices. There was an over-reliance on agency staff, nurses and care staff, and there was no clear process to assess the competence or suitability of agency staff before they worked at the home.

There was ongoing maintenance at the home. However, some immediate action was needed to make safe the environment to protect people and this had not been done, which meant people were at risk of harm.

Recruitment procedures were thorough to ensure staff were suitable to work in the care setting.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The service was last rated Requires Improvement. (Published 22 February 2019).

Why we inspected

We received concerns in relation to the management of medicines, people’s nursing care needs, staffing and overall management of the service. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

The overall rating for the service has changed from Requires Improvement to Inadequate. This is based on the findings at this inspection. Areas where improvements were needed have been consistently found during inspection since this service started in 2015. Where some improvements have been made they have not been sustained and people continue to be at risk of harm.

Enforcement

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

Following the inspection we took action to ensure the provider improved the safety in the service. We informed the local authority and clinical commissioning group (CCG) of our concerns.

The overall rating for this registered provider is 'Inadequate' and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe and there is still a rating of inadequate for any key question or overall, 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.