Archived: Meyrin House

Updated 26 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered manager was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 3 and 5 July 2017 and was unannounced. The inspection was undertaken by two inspectors on the 3 July 2017 and one inspector on the 5 July 2017.

Prior to our inspection, whistle-blower concerns were raised that people using the service may be at risk of abuse. Due to the severity of the concerns and conversations with the Local Authority we carried out an urgent inspection.

We reviewed other information that we held about the service such as notifications. These are the events happening in the service that the service is required to tell us about. We used this information to plan what areas we were going to focus on during our inspection.

As part of the inspection we spoke with one person who used the service, two relatives and five members of care staff, and the home manager and care supervisor. We also spoke with the Local Authority’s contracts, safeguarding team and the police.

Some people were unable to communicate with us verbally to tell us about the quality of the service provided and how they were cared for by staff. We therefore used observations, speaking with staff, and relatives, reviewing care records and other information to help us assess how people's care needs were being met. We spent time observing care in the communal areas and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

As part of this inspection we reviewed six people's care records. We looked at the recruitment and support records for three members of staff. We reviewed other records such as medicines management, complaints and compliments information, quality monitoring and audit information and maintenance records.

Updated 26 October 2017

Meyrin House provides accommodation and personal care for up to 18 older people. An unannounced inspection was carried out on 3 and 5 July 2017. Some people living at Meyrin House had care needs associated with living with dementia. At the time of our inspection, 13 people were living at the service.

The home did not have a registered manager in place. However prior to the inspection taking place we had received an application from the current home manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Arrangements in place to keep the provider up to date with what was happening in the service were not effective. As a result, there was a lack of positive leadership and managerial oversight.

The manager could not demonstrate how the service was being run in the best interests of people living there. Systems in place to identify and monitor the safety and quality of the service were ineffective, as they either did not recognise the shortfalls or when they did there was a lack of action to rectify them.

Views about staffing levels were mixed and some people felt that there was not enough trained and experienced staff available to meet their needs. We also found that people or their families were not fully involved in planning and making decisions about their care. We found the service not to be responsive in identifying and meeting people's individual care needs.

Staff did not have the skills and experience, and they were not deployed effectively to meet the needs of people. We found that staff did not always have enough time to spend with people to provide reassurance, interest and stimulation. There was a lack of knowledge around supporting and caring for people living with dementia including understanding how it affected people differently and how each individual should be cared for to promote their wellbeing as far as possible.

The dining experience was varied as it did not meet all the people's individual nutritional needs. As a result, the manager was unable to demonstrate that people had enough to eat and drink to support their overall health and wellbeing.

Although some of the relatives told us that staff treated people with kindness and were caring, we found the way the service was provided was not consistently caring. Staff did not always demonstrate a caring attitude towards the people they supported and some failed to promote people's dignity or show respect to individuals. The majority of interactions by staff were routine, task orientated, and we could not be assured that people who remained in their bedroom received appropriate care to meet their needs. This also meant they were socially isolated as opportunities provided for people to engage in social activities were limited.

Whilst we were concerned that some staff did not always recognise poor practice, suitable arrangements were in place to respond appropriately, where an allegation of abuse had been made. Systems in place to deal with people's comments and complaints were not effectively being used. Records we reviewed confirmed this.

You can see what action we told the provider to take at the back of the full version of the report.