The Care Quality Commission (CQC) has rated The Hamlets in Liverpool, inadequate following an inspection in October.
This inspection was prompted in part due to concerns received about staffing and the culture within the home.
The Hamlets, ran by Age Concern Liverpool and Sefton, provides accommodation, nursing and personal care to up to 30 people with mental health needs.
Following this inspection, the overall rating for the service dropped from good to inadequate. The areas of safe, effective and well-led dropped from good to inadequate and caring and responsive dropped from good to requires improvement.
Sheila Grant, CQC head of inspection for adult social care, said:
“When we inspected The Hamlets, it was disappointing to see a significant deterioration in the level of care being provided to people.
“It was concerning that people’s health conditions weren’t always managed properly. A person at risk of choking had no risk assessment in place and others with diabetes and epilepsy had insufficient detail in their care plans for staff to manage their conditions safely.
“Staff didn’t always treat people with dignity. For example, we observed staff administer a person's medication by injection at the lunch table in front of others. There was no privacy screen or curtain to protect their dignity.
“We also observed another person going in and out of people's rooms whilst they were asleep without any staff observing them or knowing where they were which placed them and others at risk of harm.
“However, it was positive that people were supported to follow their cultural heritage. One person got weekly visits from a member of their community and were provided with specific food they were accustomed to and others were supported to have weekly communion visits.
“We will continue to monitor The Hamlets and the provider has sent an action plan detailing how they will make the necessary improvements. If we are not assured people are receiving safe care, we will not hesitate to take further action.”
Inspectors found:
- The service didn’t have a robust system for recording and responding to incidents and accidents. This meant there were missed opportunities to report incidents to the relevant safeguarding authorities, leaving people exposed to avoidable risk
- Medicines were not always managed safely
- Infection prevention and control procedures were not effectively managed
- We could not see any evidence that advocacy had been considered for some people to represent them who did not have family or next of kin
- Due to some care records being inconsistent or missing, we could not always be sure people's care plans were tailored to suit them.
However:
- Staff were trained in safeguarding and knew what action to take in order to keep people safe
- The provider was safely facilitating visiting for people
- End of life care and support preferences were documented in a way which was respectful and meaningful for people
- The home was visibly clean
- Safe recruitment processes were followed. Relevant pre-employment checks were completed to ensure new applicants were suitable to work for the service.