The Care Quality Commission (CQC) has downgraded the rating for The Old School House in Madeley, Telford, from requires improvement to inadequate, and placed it into special measures to protect people, following an inspection in October.
The Old School House is a care home which provides personal care to up to seven people. There were three people using the service at the time of this inspection.
We undertook this inspection to assess if the service was applying the principles of ‘right support, right care, right culture’ and to follow up on action CQC told the provider to take following the previous inspection in June last year.
At the June inspection there were breaches of regulations regarding consent, person centred care and how the service was managed. At this latest inspection the provider remained in breach of these regulations and additional concerns and breaches were found in relation to safety, and protecting people from the risk of abuse.
In addition to dropping from requires improvement to inadequate overall, it has also dropped from requires improvement to inadequate for being safe, effective, responsive and well-led. It has been re-rated as requires improvement for being caring.
CQC inspectors also issued a warning notice, to focus the home’s attention on making rapid and widespread changes to improve people’s safety and ensure they are receiving person-centred care and support.
CQC has placed the home into special measures, which means it will be kept under close review and re-inspected to check on the progress of improvements.
Rebecca Bauers, CQC’s director for people with a learning disability and autistic people, said:
“When we inspected The Old School House, we were concerned to find they hadn’t made the improvements we told them to make after the last inspection to keep people safe. We also found further concerns at this inspection, so we have issued them with a warning notice to focus their attention on making significant improvements.
“People weren’t safe from the risks of avoidable harm. We found exposed hot water pipes which put people at risk of burns and access to the fuse box and electrical wires put at risk of being electrocuted. Also, not all wardrobes were secured to a wall so could potentially fall on people, and not all windows had restrictors in place, putting people at risk of falling out. This is unacceptable.
“The provider didn’t effectively review all incidents, accidents or near misses to see what could be done differently to stop them happening again in future. For example, there were three occasions where someone's actions could have resulted in them coming to harm. When we asked the manager about these incidents, they were unaware of them. They failed to complete a risk assessment based on the known risks to this person which must be addressed to prevent them from coming to harm.
“Activities were limited and didn’t encourage people to have the independence they deserve. One relative told us the management team had failed to apply for a bus pass in time, so specific activities have had to stop for about six weeks.
“We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, and independence that most people take for granted and it’s unacceptable that the people they relied on to keep them safe and live meaningful lives were treating them this way.
“We’ve shared our concerns with the provider, and we’ll be monitoring the service closely, including through future inspections, to make sure the necessary improvements are carried out and that people are safe whilst this is happening. If we’re not assured people are receiving safe, person-centred care, we won’t hesitate to take further action.”
Inspectors also found:
- People were at the risk of abuse as the management could not evidence they had effectively monitored incidents or situations or pass on information of concern to others when needed
- People still did not always have the opportunity to gain new skills or experience new things. The provider did not promote independence or the development of social or vocational skills
- The completion of mental capacity assessments was inconsistent and did not follow best practice. There was a lack of understanding and application of the mental capacity act or the decision-making process when people were unable to make decisions for themselves
- People were not involved in the development of their care and support plans and the plans in place did not accurately reflect their current needs and wishes
- The management team failed to promote equality and diversity. There was no record available of people's individual characteristics including, ethnicity, disability, gender, religion or sexuality. This put people at risk of losing their personal identities and the characteristics of what makes them who they were
- People's privacy and dignity was not respected by the management team. The provider had introduced CCTV in communal areas. None of the staff or the management team could tell inspectors who is able to actively watch the CCTV or in which circumstances this is monitored.
The report will publish on CQC’s website in the next few days.