Archived: Hillgreen Care Limited - 14 Colne Road

This focused inspection took place on 22 January 2016 as we had received serious concerns from the local authority as part of a food safety inspection that had taken place. We checked whether the provider was in breach of legal requirements in relation to Regulation 15 and 17 concerning premises and equipment and good governance.

At the time of the inspection there was no registered manager in place. 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.

At the last comprehensive inspection which took place on 19 November 2015, the provider was found to be in breach of Regulations 9, 12, 16, 17, 18 and 19. These covered safe care and treatment, fit and proper persons employed, staffing, person centred care, receiving and acting on complaints and good governance. Not all of the above Regulations were looked at as part of this focused inspection. However, the provider was found to be in continued breach of Regulation 17.

On 19 January 2016 a food safety inspection had been carried out by the local authority. This had highlighted serious concerns around the safe management of food, health and safety risks and infection control issues. The inspection made reference to certain issues which included out of date food, cross contamination and appropriate storage of foods. The report also highlighted health and safety issues which included structural concerns of the building, pest control, cleanliness of the home and certain pieces of equipment within the home and the poor condition of the kitchen and the cupboards within the home and also raised concerns about the knowledge of staff in relation to food safety.

At our inspection, we found that the provider had implemented some improvements in response to the recommendations that the local authority had made. However, at the time of this focused inspection we noted that certain remedial actions which could have been implemented immediately had not been applied.

There were inadequate arrangements in place to prevent and control the spread of infection and ensure that the premises and equipment were clean. There was no infection control policy in place and staff were not adhering to a cleaning schedule. We saw evidence of poor infection control practice. This included overflowing bins, unclean areas and inappropriate storage of clinical waste. The storage of hazardous substances was not safe and presented a risk to people using the service. The premises were not being properly maintained.

There was ineffective management oversight of the home and the service it provides. The provider had failed to appoint someone to the role of manager since early December 2015. The deputy manager was not being provided with sufficient support to ensure that the service was being effectively run. The provider had failed to identify serious issues in relation to the running and management of the service. The systems in place to identify issues were either ineffective or had not been implemented. In relation to a number of issues, action appeared to be taken by the provider only when external independent agencies identified issues. Some of these issues potentially placed people and staff at risk of harm. When action was taken, it was not always effective or addressed all of the issues that had been highlighted.

Certain issues around the structure and condition of the building had been highlighted to senior managers by staff working within the home. However, no action had been taken.

During this inspection we found the provider to be in breach of Regulation 15 and 17. This report only covers our findings in relation to these breaches. We are in the process of taking enforcement action against the provider. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for 14 Colne Road on our website at www.cqc.org.uk.

We will undertake another unannounced inspection to check on all other outstanding breaches of regulations identified for this service.

14 Colne Road is a residential care home providing care for up to six younger adults with learning disabilities. On the day of the inspection there were three people using the service.

Protocols to keep people safe in the event of an epileptic seizure were not always being followed which was putting people at risk of unnecessary and, potentially, significant harm.

Staff had not been provided with specific training in the use of an emergency epileptic medicine so this potentially lifesaving drug could not be administered if required.

During this inspection we found the provider to be in breach of Regulation 12 (1)(2)(a)(b)(g) in relation to assessing risk and the safe management of medicines.

This report only covers our findings in relation to these breaches. We are in the process of taking enforcement action against the provider.

We will undertake another unannounced inspection to check on all other outstanding breaches of regulations identified for this service.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that these plans were being reviewed on a regular basis with input from the person using the service where possible.

Appropriate arrangements were in place in relation to the recording of medicine. Medicines were being kept safely, were being safely administered and were being disposed of appropriately.

Staff had undertaken training that was appropriate and relevant to the needs of the people using the service. Staff were able to describe how training had improved their understanding of the issues faced by people they supported and how it had benefited their working practices.

People we spoke with were positive about the care and support provided at the home. We observed staff supporting people in a friendly manner and people appeared very comfortable with the staff at the home. One person commented 'I'm happy.'

Staff we spoke with understood the importance of obtaining the consent of the person before any care or treatment took place. People we spoke with confirmed that staff asked for their permission before any care and support was provided.

People told us that they were happy at the home and had no concerns or complaints about their care. We saw that there were regular house meetings so that people could raise any issues or concerns with the manager.

People's healthcare and social care needs were not always being recorded in sufficient detail to ensure their safety and welfare. People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Records showed and staff told us there were gaps in the essential training they needed to ensure the safety and welfare of people they supported.

We saw evidence that people who use the service were able to go out to the local community. People attended day centres, colleges and voluntary work experience. One person told us, 'I go to college.'

Staff had a good understanding of the needs of the people they supported and people's care plans and risk assessments were being reviewed and updated with the person's involvement where possible.

People who use the service told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, the manager or their key worker if they needed to.

Staff told us they felt supported by the management and that there were good training opportunities available within the organisation.

There was evidence that the manager and provider spoke with people using the service to gain their views about their care as well as identifying any areas for improvements. One person told us, 'they ask if we're happy.'