The Care Quality Commission (CQC) has told Paramount Care (Gateshead Ltd), to make urgent improvements following inspections in July, August and September.
CQC carried out this comprehensive inspection after receiving concerns in relation to the safety of people using the service.
Following the inspection, Paramount Care (Gateshead Ltd) has been rated inadequate overall and inadequate for being safe, effective, caring, responsive and well-led. It was previously rated good overall and good in all five domains. The service has now been placed in special measures.
CQC has also imposed conditions on Paramount Care (Gateshead Ltd). It is unable to accept any new people without written agreement from CQC, it must provide regular reports to CQC ensuring accidents, incidents and safeguarding concerns are appropriately managed, and make sure infection prevention and control measures are in place to prevent and control the spread of COVID-19.
Paramount Care (Gateshead Ltd), is a residential care home providing personal care for up to 20 people with a learning disability and autistic people. At the time of inspection, 18 people were living at the home.
Debbie Ivanova, CQC’s deputy chief inspector for people with a learning disability and autistic people, said:
“When we inspected Paramount Care (Gateshead), we had serious concerns for the people living there. We observed a negative staff culture, and no leadership from the manager which was having a detrimental impact on the care people were being given. People relied on staff to act as their voice, and as advocates for them, this simply wasn’t happening.
“People were at serious risk of harm due to risks not being fully assessed or monitored. We found that one person's risk assessment was not reviewed after they had attempted suicide and they managed to attempt it again, in the same way on a further two occasions within a short space of time. This standard of care is totally unacceptable, and these two incidents could have been prevented if staff had taken appropriate measures and learnt from previous incidents.
“We expect health and social care providers to guarantee autistic people and people with a learning disability a life of their choosing that meets both people’s needs and aspirations. People should have the choices, dignity, independence and good access to local communities that most people take for granted, this was not happening at this home.
“We started the inspection process in July, and our concerns were still not addressed during further visits, months later. Due to this, we had no choice but to impose conditions on the service to protect people.
“We will continue to have regular meetings with the provider and monitor them closely to make sure improvements are being made so that people are not put at risk and are living in an environment suitable for their needs. If we’re not satisfied enough improvements have been made, we will not hesitate to take the necessary action to prevent this provider from operating so that people receive the safe care they deserve.”
Inspectors found the following issues at the service:
- We found that infection prevention and control processes were not being followed by staff and placed people at risk of harm. Staff were not wearing PPE or were wearing it inappropriately
- People were not receiving person-centred care that promoted their independence and their care records did not accurately reflect the support they needed
- People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Advocate support was not always sourced in a timely way
- The service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care used at the service did not promote people's independence or choice
- There was a negative staff culture at the service and there was no leadership by the registered manager
- Medicines were not managed safely. Policies and processes in place did not provide sufficient guidance or information to allow staff to safely support people with their medicines
- Staffing levels were adequate, but the deployment of staff did not always ensure people were supported safely, due to the additional tasks staff had to complete as part of their working day. People did not always receive care from staff who knew them well or were aware of their needs
- The quality and assurance systems in place were not effective, audits were not fully detailed, and records were not always present. The provider failed to ensure the quality and safety of the service was monitored effectively. Records at the service, including people's care records, were not always present, accurate or reviewed
- The environment was lacking personalisation and was more like a clinical environment like a hospital than reflective of the fact that this was people’s home. The fire risk assessment had not been reviewed since 2017 and the provider could not provide evidence to demonstrate issues identified as requiring action in 2017 had been completed
- Staff did not feel supported by the registered manager or management team or completed all necessary training required to provide safe care to people
- Due to the failings identified at the service, the local authority and Clinical Commission Group (CCG) have worked with CQC to provide additional support to the provider to ensure people receive safe care. A private consultancy company is now working with the provider's management team to offer support and guidance to improve the service, recruit new staff and work with the provider to ensure they understand the regulations fully and their responsibilities
- However, some staff had worked with people for a long period of time and knew people well. People CQC spoke with said staff supported them kindly.
Full details of the inspection are given in the report published on our website.
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