31 July 2017
During a routine inspection
There was not a registered manager at the service at the time of our inspection. 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.
People were not always protected from risks to their wellbeing because there was not a robust staff recruitment process in place. Criminal record checks and references were not always obtained prior to a staff member starting work at the service. People were not always protected from risk of harm because environmental checks and risk assessments were not always completed or up to date.
There was a negative culture at the service and staff morale was low. There was poor communication between the senior management team and the staff at the service. The service was not organised in a way that always promoted safe care through effective quality monitoring. There was inconsistent management at the service as the manager had resigned two weeks before the inspection and the deputy manager was acting as the service manager. As a result, staff meetings were not being routinely held and the acting manager was not aware of the statutory obligation to report all issues that affected the service to the Care Quality Commission.
People were supported to eat and drink enough but people were not protected from the spread of infection because the service was providing people with out of date food to eat. .
People were protected from risks resulting from their specific health and care needs because effective risk assessments were in place to guide staff about how to manage specific risks. People were supported to obtain care and treatment from health care professionals and medicines were managed adequately.
People felt safe and were protected from the risk of potential abuse. Staff were knowledgeable about safeguarding processes and knew what to do if they had concerns about the service. Staff were observed to be caring and promoted people’s independence and dignity.
There were enough staff to meet people’s needs. People were involved in planning their care and care records included information about people's likes and dislikes and promoting their independence.
Staff were trained to carry out their roles and newly appointed staff were supported in their role by an induction period.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
We found five breaches of the Regulations around fit and proper persons employed, safe care and treatment, complaints, statutory notifications and good governance. We made one recommendation in relation to meeting nutritional and hydration needs. You can see what action we told the provider to take at the back of the full version of the report.