Background to this inspection
Updated
2 April 2016
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 provider is 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 21 January 2016 and was unannounced. The inspection team comprised of two inspectors.
As part of the inspection we looked at the information we already had about this provider. We looked at information received from the local authority and the statutory notifications the provider had sent to us. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. These help us to plan our inspection.
During the inspection we met with all of the people who lived at the home. Some people’s needs meant they were unable to verbally tell us how they found living at Lichfield Road, and we observed how staff supported people throughout the inspection. As part of our observations we used the Short Observational Tool for Inspection (SOFI). SOFI is a way of observing care to help us understand the needs of people who could not talk with us.
We spoke with the newly appointed team co-ordinator, three care staff, one care staff who worked night shifts and two agency staff. We looked at parts of three people’s care records, the medicine management processes and at records maintained about staffing, training and the quality of the service. We spent time observing day to day life and the support people were offered. Following our visit we spoke with four relatives of three people and the manager of the service. The manager also sent us further information which was used to support our judgment.
Updated
2 April 2016
This inspection took place on 21 January 2016 and was unannounced.
At the last comprehensive inspection in September 2015, this provider was placed into special measures by the Care Quality Commission (CQC). Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do meet legal requirements in relation to breaches of regulations. We undertook this full comprehensive inspection to check they had followed their plan and to confirm they now met legal requirements. This inspection found there were enough improvements to take the provider out of special measures. The provider now met their legal requirements but further improvement was required.
Lichfield Road is a residential home, where care and support is provided to five people who have learning disabilities or have mental health support needs. There were four people living in the home at the time of the inspection.
The accommodation was provided in single bedrooms; the home had bedrooms and bathrooms on the ground and first floor. There were shared lounges and dining facilities available on the ground floor.
At the time of this inspection there was no registered manager in post. 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. A manager had been appointed to run the home and was in the process of applying to become the registered manager. However they were not able to work at the home on a full time basis as they also had responsibility to manage another location which was located several miles away. They were not available during the inspection visit as they were on a training day.
One person told us they were happy at the home but other people were unable to verbally share their views about their experience living in the home.
Our inspection identified that changes and improvements had occurred across the service. Hazardous substances that may pose a risk to people were now kept securely. A person who required the use of a hoist to move was supported by staff to do this in a safe way. Arrangements had improved to make sure staff responded appropriately in the event of a fire occurring at the home and infection control procedures had been improved. The actions taken had reduced some of the risks to people’s safety but additional safety measures were needed in regards to the risk of a person falling out of bed. We were sent evidence of action being taken immediately following our visit.
Safeguarding procedures were available in the home and staff we spoke with knew to report any allegation or suspicion of abuse.
Previously there was not enough staff to meet personal care needs of people in a timely manner or to accompany people to go out of the home should they have chosen to go out at the same time, this restricted people’s choices. Changes to how staff were deployed and a recent reduction in the numbers of people living at the home had meant that staff were better able to support people.
People received the correct medication at the correct times. All medication was administered by staff that were trained to do so but some minor improvement was needed to ensure medication was administered and recorded in a safe way.
People were supported to maintain good health and to access appropriate support from health professionals where needed. Development was needed of the systems in place to promote good continence care and to make sure people were a healthy weight. People were supported to eat meals which they enjoyed and which met their needs in terms of nutrition and consistency.
We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting. We saw staff treating people with respect and communicated well with people who did not use verbal communication.
New staff were provided with an induction that would ensure they knew how to care for people and would ensure they could work safely. Training and supervision arrangements for staff had improved and further training for staff was scheduled.
There was a complaints procedure which was on display and was available in an easy to read version with pictures. Records to evidence the action taken in response to complaints being received had been completed but needed improvement.
Changes had taken place in the management staff team, in addition to the manager there was a team co-ordinator in post and both were now being supported by a newly recruited area manager. Whilst we received positive feedback from staff about the manager they were only able to spend limited time at Lichfield Road as they were also responsible for managing another care home. Arrangements for checking the safety and quality of the service had improved since our last inspection but further improvement was needed to ensure people were provided with a good service.