The Care Quality Commission (CQC) has told the provider of SMS Care Limited in Blackburn, Lancashire, to make urgent improvements following an inspection in June and July.
This unannounced inspection was prompted by a review of the information held about the service and to check on the progress of improvements CQC told the provider to make, after issuing them with a warning notice in October last year around safe care and treatment and good governance.
Following this recent inspection, the provider had made some improvements, however they remained in breach of regulations.
The home’s overall rating and for being safe and well-led, remains inadequate. The ratings for being effective and responsive have declined from requires improvement to inadequate, and caring has gone from good to requires improvement.
The service remains in special measures which means it will be kept under review by CQC and re-inspected to check significant improvements have been made.
SMS Care Limited is a residential care home for autistic people and people with a learning disability. At the time of this inspection there were six people using the service.
Rebecca Bauers, CQC’s director for people with a learning disability and autistic people said:
“When we inspected SMS Care Limited we were disappointed to find the provider hadn’t addressed all of our concerns raised at the previous inspection and they were still in breach of regulations. We found there were significant shortfalls with the leadership team and the culture they created didn’t ensure people were receiving a high standard of care.
“Leaders here were unable to guarantee people were receiving the right care or support that autistic people and people with a learning disability should be able to expect. We found people weren’t safe because there wasn’t always enough staff to meet people’s needs and they weren’t always recruited safely.
“Additionally, people weren’t always receiving appropriate care to meet their individual needs because care plans failed to record all the necessary information. Also, end of life care plans hadn’t been developed, and none of the staff had undertaken any end of life training. This must be addressed as a priority to enable staff to provide high quality care at such an important time in people’s lives.
“Leaders here haven’t taken our previous feedback and used it to make the rapid improvements we told them we expected to see.
"People deserve a much higher standard of care than what’s being provided by SMS Care Limited. The service will remain in special measures, and we will be keeping it under close review to make sure people are safe. If we don’t see significant improvement, we won’t hesitate to take further action, even if this results in the closure of the service."
Inspectors found the following during this inspection:
- 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
- Safeguarding allegations were not being acted upon or managed appropriately. Referrals were not being made to the relevant authorities
- Medical assessments and reviews were not always completed. There was no record missed appointments had been followed up. Professionals told CQC the service did not engage with them
- Medicines were not managed safely
- Individual risks were not being assessed or managed safely
- Some improvements were needed in relation to infection prevention and control
- People’s weight was not being recorded appropriately and one person's individual needs in relation to their meals had not been provided. Supplies of fresh food was limited and some foods were not stored in line with guidance
- No environmental risk assessments were completed
- A system had still not been developed to ensure complaints or concerns were managed.
However:
- People and some relatives felt involved in decisions about the care being provided.