13 January 2015
During a routine inspection
We carried out this unannounced inspection on 13 January 2015. When we last inspected the home on 2 January 2014 we found the provider was meeting all the requirements.
Carwood Residential Home provides care and accommodation for up to 13 people who have a learning disability. At the time of our inspection there were 10 permanent people and one person on emergency placement with their own support living in five separate flats across the home. The registered manager was no longer in post and had recently submitted an application to CQC to deregister. A service leader was employed and was responsible for the day to day management of the home closely supported by a group 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.
Staff had received training to keep people safe and knew their responsibility to protect people from harm or potential abuse. They knew how to recognise abuse and how to report it. Improvements had been made to ensure people received their medicines as prescribed. We found staffing levels and the deployment of staff needed to be reviewed to ensure the safety of the people using the service at all times.
People were positive about the care and support they received. We found people were supported by an established staff team who were trained and supported to do their job. We observed positive engagement between staff and people living at Carwood. Staff were kind, respectful and attentive to people's needs. They worked alongside people, helping them with tasks, rather than doing things for them. People’s privacy and dignity was respected and their independence was promoted. People took part in some social and recreational activities in the local community however, opportunities were limited during evenings and weekends due to insufficient staffing. People were supported to access a range of healthcare services and their individual communication needs were understood and met.
We found a person’s ability to make decisions had not been assessed. Staff training records showed that less than half the staff team had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Not all the staff we spoke with had a clear understanding of possible factors that could contribute to a deprivation of liberty. Improvements were needed to ensure that people’s rights were protected.
People were aware of the changes in the management and leadership of the home following a recent restructure of the provider’s services. People considered the home was well managed and told us the service leader was open and approachable. We saw the provider had elements of a quality assurance framework in place. However, we found this required improving and more formal ways of capturing people’s views and decisions assessed and recorded.
We found three breaches in Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 .You can see what action we told the provider to take at the back of the full version of the report.