The Care Quality Commission (CQC) has rated Ideal Home, Shrewsbury in Shropshire, inadequate overall following an inspection in June.
Ideal Home is a residential care home, run by Minster Care Management Limited, providing personal care for up to 50 people. At the time of this inspection there were 36 people living at the home. There are two sides to the home, one supports older people living with dementia and the other supports people with continuing mental health care needs.
CQC carried out this inspection to follow up on actions the provider was told to make at a previous inspection. At that inspection there were breaches of regulation regarding recruitment, governance processes, hydration and nutrition.
At this inspection improvements had been made in some areas. However, additional concerns were identified, and the provider remained in breach of regulations.
Following the inspection, the overall rating for the service has declined from requires improvement to inadequate. The ratings for being safe and well-led have also dropped from requires improvement to inadequate, and the ratings for being effective and responsive to people’s needs have remained rated as requires improvement. Caring has dropped from good to inadequate.
Amanda Lyndon, CQC head of inspection for adult social care, said:
“When we inspected Ideal Home, we found leaders and the culture they created didn’t provide assurance the service was delivering high-quality care.
“The physical environment wasn’t safe for people. We found a broken stair hand-rail, a window restrictor on a first floor sash window was missing, a fire door had been altered and didn’t close, some radiator valves were missing creating sharp edges, a ceiling light had exposed wires and one person’s hot water exceeded the safe maximum temperature creating a risk of scalding.
“Additionally, the environment wasn’t decorated or adapted to a consistent standard to meet people’s needs. There was a lack of signage to direct people or help them find their way round the building. Some bedrooms didn’t have names on the doors or other indicators, so they knew how to find their room.
“Staff didn’t always explain or present things in a clear and easily understood way for people to be involved with what was happening. For example, one member of staff provided a lunch time meal for someone with significant visual impairment. They just put it down on the table in front of them, didn’t announce themselves or explain what was happening. There was no consideration for this person’s individual needs.
“Another person told us they had to ask every time they wanted to leave the building and for staff to unlock the doors. This person had capacity to make decisions for themselves and attended work on a regular basis unaccompanied. They felt this restricted their freedom and no one had explained the rationale for this restriction.
“The overall rating for this service is inadequate and is in special measures. We will keep it under review and, if we don’t propose to cancel the provider’s registration, we will re-inspect to check for significant improvements.”
Inspectors found the following during this inspection:
- People were not always safe as the physical environment was not safely maintained. The provider failed to identify risks or put effective measures in place to mitigate potential harm. People were not protected from the risks of abuse or neglect as the provider failed to consistently follow reporting procedures when concerns were raised with them. The provider was not promoting effective infection prevention and control practices throughout the building. The provider did not consistently learn from incidents, accidents, or near misses as their processes were inconsistent and did not robustly identify and promote good practice
- People were not always supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible or in their best interests; the application of policies and systems in the service did not always support best practice. People did not have concerns or complaints effectively managed
- The provider did not always promote people’s dignity or respect. People’s protected characteristics were not known by the management team or promoted
- The provider’s quality checks were ineffective in identifying or driving good care. The provider had not always told the care quality commission about significant events.
However:
- People received their medicine safely and as prescribed. When required the provider referred people for additional support with their diet and hydration
- People were supported by trained and supported staff. The provider followed safe recruitment practices when employing new staff.