3 November 2016
During a routine inspection
At a comprehensive inspection in December 2015 the overall rating was Inadequate and the service was placed into special measures by the Care Quality Commission (CQC). Four breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 were identified. We found significant risks to people due to the management of medicines. We also found risks to people’s environment that meant people were not protected in the event of a fire. People and staff did not have relevant risk assessments in place to ensure their safety. People in the service did not receive care and support that was individualised to their needs. Following our previous inspections we had concerns with the general leadership and management of the home. A management team had been put in place to oversee the day to day running of the home until the appointment of a registered manager. Following the inspection, we received regular action plans which set out what actions were to be taken to bring the service up to standard.
We undertook another inspection on 4 May 2016 in line with our special measures guidance to see if improvements had been made. We could see that some action had been taken to improve people’s safety but further improvements were needed to ensure people were safe. For example, risk assessments had not been completed for people that self-medicated and not all actions had been completed to improve fire safety. Staff had not undergone lone working risk assessments and were not receiving regular supervision to support them. Complaints had not been processed in line with the complaints policy. Systems and processes in place to ensure the regulations were met had not identified the issues we found in the inspection and therefore were not effective in keeping people safe. There were continued breaches in Regulation 9, Regulation 12 and Regulation 17 with an overall rating of Inadequate. Therefore, the service remained in special measures meaning significant improvements were required, or further enforcement action could be taken. Following this inspection we asked the provider to submit monthly actions plans.
At this inspection on 3 November 2016, we found considerable improvements in the service. The environment had improved noticeably and health and safety audits meant any issues that may cause concern were picked up on swiftly and actioned. The management of medication had improved, although there were some areas to improve upon. We have made a recommendation about the management of some medicines.
Staff had received appropriate training to support them in their roles and staff told us they felt well supported.
We observed pleasant and friendly interactions between staff and people who used the service. The people with whom we spoke told us they were happy with the care they received
People had care plans in place which were person centred and provided relevant guidance for staff about how to care for and support people. These were reviewed at regular intervals and updated where necessary. We found that people were receiving support that was relevant to their circumstances and person centred to identify achievable goals to help them towards independent living. Activities had been discussed and were offered regularly to people in the service.
We found there were effective systems in place to monitor the quality of the service provided and regular checks were undertaken in all aspects of running the home. Commissioners had reported improvements in the service.