3 June 2019
During a routine inspection
Rating at last inspection: At our last inspection on 5 November 2018 we found breaches of regulations because risks relating to people’s care and support were not always managed safely. Care plans were not reflective of people’s care needs and were not being followed by staff. Staff had not always referred people to health care services where they had identified concerns with their health. Staff had not always followed the instructions of health care professionals when supporting people. Sufficient numbers of suitably qualified, competent, skilled and experienced staff were not always deployed at the home to meet people’s care and support needs. The home relied heavily on agency staff, some of whom were not fully aware of people’s needs.
The principles of the Mental Capacity Act 2005 (MCA) had not always been adhered to where people lacked capacity to make decisions for themselves. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible. Staff did not always treat people with respect, or in a caring way. People were not consistently provided with a range of appropriate social activities that met their needs. We identified one incident that was a safeguarding concern which had not been properly reported or recorded. The home’s quality monitoring systems were not effective.
The home was rated inadequate overall and was placed into ‘Special Measures’.
At this inspection we saw that the registered manager and the management team had addressed these breaches and were compliant with the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Whilst we found improvements had been made in safe some areas required further improvements. The systems and processes that have been implemented in well led had not been operational for enough time for us to be sure of consistent and sustained good practice. We will look at these systems again at our next inspection of the service.
People’s experience of using this service: Risks to people using the service were assessed, reviewed and managed appropriately. People’s care and support needs were assessed before they moved into the home. They had care plans in place that reflected their needs, and these were followed by staff. Staff referred people to health care services when they identified concerns with their health. Staff followed the instructions of health care professionals when supporting people. The home had recruited more full-time staff and were no longer reliant on agency staff.
The principles of the MCA were adhered to where people lacked capacity to make decisions for themselves. Staff treated people with respect. People were provided with a range of social activities that met their needs. Safeguarding concerns were reported to the appropriate authorities when required. There were effective systems in place to assess and monitor the quality of the service.
People’s medicines were managed safely. Appropriate recruitment checks were carried out before staff started working at the home. There were procedures in place to reduce the risk of the spread of infections. Staff had received training and support relevant to people’s needs. People were supported to maintain a balanced diet.
People’s wishes relating to their end of life care needs had been discussed with them or their relatives [where appropriate] and recorded in their care files. People and their relatives [where appropriate] had been consulted about their care and support needs. The home had a complaints procedure in place.
The registered manager had worked in partnership with health and social care providers to plan and deliver an effective service. The provider took people, their relatives and staff views into account through meetings. Staff enjoyed working at the home and said they received good support from the registered manager and management team.
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
As the provider has demonstrated improvements and the service is no longer rated inadequate for any of the five key questions, it is no longer in special measures.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk