Archived: Masson House

Updated 19 December 2023

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 had previously provided a rating for the service under the Health and Social Care Act 2008.

This was a targeted inspection to check whether the provider had met the requirements of the urgent conditions we had imposed on their registration on 3 October 2023, in relation to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection team

The inspection team consisted of 2 inspectors and an Operations Manager. The inspectors carried out the onsite inspection activity. The Operations Manager was offsite and supported the inspection by reviewing copies of people’s medicine administration records obtained by the inspectors.

Service and service type

Masson House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Masson House is a care home which does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. The registered manager was also the provider and owner of the care home.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

As part of the urgent conditions applied to the provider’s registration, the provider had already sent us some documents showing what changes they stated they had made at the care home. We reviewed those before completing the inspection. We also obtained feedback on the care home from the Local Authority Adult social care team. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and discussed with them the requirements of the urgent conditions applied to the provider’s registration. We checked the care home environment and sought evidence that the conditions had been complied with. We spoke with 5 people who use the service about their experience of living at the care home. We checked various rooms of the care home and also reviewed people’s medicine administration records. We observed staff interactions with people.

Updated 19 December 2023

About the service

Masson House is a residential care home providing accommodation and personal care to up to 17 people. The service primarily provides support to older adults but can also support people over the age of 18. At the time of our inspection there were 16 people using the service. The care home is a large adapted domestic style building, which also has a purpose-built ground floor extension.

People’s experience of using this service and what we found

People were not always protected from potential abuse. The provider did not ensure all allegations of potential abuse were notified to the local authority or CQC. People were not always protected from the risk of potential harm from scalding, burns, or legionella infections. A suitable fire safety risk assessment was not in place.

People's medicines were not always safely managed, administered, or recorded consistently. Guidance for staff on people's individual medicines was not always accurate. People were not always supported by enough staff to meet their care needs.

People lived in a care home which was not always clean. There was an unpleasant urine odour present in several areas of the care home. The laundry room had evidence of black mould present which was a potential risk to people's health.

People had not been appropriately assessed to determine if they had the mental capacity to consent to live at the care home. People were effectively deprived of some aspects of their liberty, but the provider had not applied for authorisation from the relevant local authority. One person told us they did not want to live at Masson House but there was no evidence found that they were being supported to move to a different care home

People's care plans were not regularly reviewed and contained contradictory information about people's care and support needs. The provider was not able to evidence all staff had received the necessary training to enable them to care for people safely.

People had limited meal options offered to them and their preferences were not always identified and actioned. People were not always supported to access specialist advice from external healthcare professionals in a timely manner.

People told us they found the care home was sometimes cold and staff told us they did not have access to the heating controller to enable them to increase the temperature in the care home. People were not always supported to receive their 'as and when required' medicines in a timely manner, which had a particular impact on people who had been prescribed pain relief medicines.

Staff respected people's privacy when providing personal care support, and people were supported to dress appropriately to maintain their dignity. People were not often supported to take part in organised activities at the care home. People on end-of-life care did not always appear to be treated with compassion and empathy.

People were not supported to have maximum choice and control of their lives and the provider did not have suitable processes in place to ensure potential restrictions on people’s liberty were legally authorised and in their best interests; the policies, systems, and practice in the service did not take into account the requirements of the Mental Capacity Act 2005.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and/or who are autistic.

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

Rating at last inspection

The last rating for this service was Good (published 11 January 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report. The provider has told us they will take action to address the issues we found. Please see the Safe, Effective, Caring, Responsive, 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 Masson House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safety, safeguarding, medicines management, staffing, hygiene, consent, and the management of the service at this inspection.

We imposed conditions on the provider's registration with CQC, requiring the provider to send us assurances they had taken the required action to ensure people were safely supported. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore 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 of 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.