Carrick

Updated 28 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Carrick is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Carrick is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the new provider had taken over. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the service and met with three people living at Carrick. We observed staff interacting with people. We spoke with the quality and improvement lead and 3 members of staff. We looked at two peoples care records, rotas, incident reports, daily notes, medicine records and other records in relation to the running of the service. Following the inspection visit we spoke with a further 4 members of staff, an external professional and 4 relatives.

Updated 28 September 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Carrick is a residential care home providing personal care to 4 people at the time of the inspection. The service can support up to 5 people.

People’s experience of using this service and what we found

Right Support

Systems to develop people’s skills, confidence and independence were not robust.

Staff supported people to take part in activities in their local area. There was a lack of focus on supporting people to be meaningfully engaged while at home.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff supported people with their medicines in a way that promoted their independence. Before administering medicines to help people when they were distressed staff considered other ways of supporting people.

Systems were in place to record any incidents or accidents. These records did not consistently document lessons learned.

Right Care

People living at Carrick had varying needs and these could impact negatively on others. This meant people’s individual needs could not always be met.

Not all staff had the appropriate knowledge and skills to support people safely.

Care and support was not focused on people’s quality of life. There was an absence of goal setting or effective skills mapping.

Right Culture

Health and safety checks had not been carried out consistently in line with the provider’s schedule.

Staff were supported by managers and were offered the opportunity to debrief after any incident. These debriefs were not always recorded which meant opportunities to learn from incidents might be missed.

There were no systems in place for gathering people’s views.

Staff had been safely recruited and there were enough staff available to meet people’s needs with the support of bank staff and agency staff. The new provider was pro-actively recruiting and exploring new avenues for identifying possible staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

In September 2022 the provider was asked by the Local Authority to take over the care and support at this location from another provider, the care transferred to the new provider in November 2022.

This service was registered with us on 21 November 2022 and this is the first inspection.

The last rating for the service under the previous provider was inadequate, published on 26 August 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We needed to check to see if the provider had made improvements since taking over the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches in relation to safe care, consent to care, person-centred practices and management of the service.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.