An Isle of Sheppey care home for people with learning disabilities, physical disabilities, mental health conditions and autistic people has been rated inadequate and placed in special measures by the Care Quality Commission (CQC), following an inspection in January.
Little Oyster Residential Home in Minster-on-Sea, which can care for up to 64 people and was rated requires improvement after its last inspection, was inspected to assess whether it had made improvements CQC previously told it were needed.
In addition to being rated inadequate overall following the latest inspection, the service’s ratings for being safe and well-led have dropped from requires improvement to inadequate. It has again been rated requires improvement for being effective, caring and responsive.
To support its improvement and to ensure people’s safety, CQC has placed the service in special measures. This means it is being closely monitored and it will be inspected again to assess whether it has addressed the issues inspectors identified.
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 concluded.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said:
“Following our previous inspection, we told Little Oyster Residential Home where it needed to improve to ensure people receive the quality of care they should expect as standard.
“We saw some small pockets of improvement, but there were more areas where standards had declined – which is why we’ve rated the service inadequate.
“A lack of oversight from senior leaders was behind most of the problems we saw, meaning they were unable to identify issues and develop solutions. This manifested itself in several ways.
“We saw that people weren’t supported to set or achieve goals, such as learning new skills, or helped to pursue their interests by staff. This is unacceptable.
“Staff didn’t always follow processes designed to keep people safe, such as those for medication – which meant some people didn’t receive their medication as required.
“There were also other policies that weren’t always followed, including safeguarding to protect people from the risk of abuse.
“Following the inspection, we reported our findings to the service’s leaders. This means they know where there’s good practice on which they can build, and where there are issues that they must address.
“We’re monitoring the service closely and we’ll inspect it again to assess whether improvements have been made. If progress isn’t forthcoming, or if people are at immediate risk of harm, we won’t hesitate to take action to ensure people’s safety.”
The inspection found:
- Staff did not provide effective support to identify people's aspirations and goals or assist them to plan how these would be met. Staff did not always focus on people's strengths and promote what they could do
- There was an inconsistent approach to supporting people to learn and maintain skills
- Pre-admission assessments had not always been used to develop people's care plans. Care plans also contained conflicting information
- The service had systems and processes to safely administer and record medicine use, however these were not always followed, and medicines were not managed safely
- People were not supported to have maximum choice and control of their lives or supported in the least restrictive way possible
- Although most people had improved experiences regarding their dignity, respect and human rights compared to the previous inspection, people were not always treated with dignity and respect
- Although staff understood how to protect people from poor care and abuse, safeguarding issues had not always been identified and reported appropriately
- Records showed basic pre-admission assessments had been carried out to identify people's needs. However, these assessments had not always been used to develop care plans to provide staff with clear information about how to provide care and support
- Quality monitoring processes were not robust and had not always identified concerns. There was no senior managerial oversight of the quality monitoring processes, which contributed to the quality of service declining since its last inspection.
However:
- The service provided people with care and support in a clean and well-equipped environment. It was also undergoing a programme of redecoration and repair
- Most staff had the necessary training
- Since the last inspection, people, their relatives and staff had been encouraged and supported to provide feedback about the service. Most people and staff felt listened to
- Complaints made to the service had mostly been responded to in line with its policy.