Archived: The Hermitage Charity Care Trust

Updated 6 July 2021

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 following complaints received. 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 Care Act 2014.

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 two inspectors.

Service and service type

Hermitage charity Care trust is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The local authority made us aware of some support that had been provided to the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager and care workers.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. We also viewed records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at daily care notes and risk assessments.

Updated 6 July 2021

About the service

The Hermitage Charity Care Trust is a residential care home providing personal care to 30 females aged 65 and over in one adapted building. At the time of the inspection 26 people were receiving care and support.

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

Medicines were not always managed in a safe way. People were not protected from risk as incidents that had occurred had not been identified as safeguarding issues and had not been properly investigated.

Known risks to people’s health had not always been assessed and planned for.

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 to ensure they supported people in the least restrictive way possible and in their best interests.

The provider had failed to make any improvements since the last inspection. There was a lack of systems in place to monitor the safety and quality of care being provided. Notifications of incidents we should have been notified of had not been sent to us or the local safeguarding team. Lessons were not always learned when things went wrong.

People and their relatives told us they felt well supported. The environment was clean and tidy and was adapted for the people living there. Staff were recruited safely.

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

The last rating for this service was requires improvement (published 27 January 2020)

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection improvements had not been made and the provider was still in breach of regulations.

The last rating for this service was requires improvement (27 January 2020). The service has now deteriorated to inadequate. This service has been rated less than good for the past two consecutive inspections. This will be the third consecutive time the provider has failed to achieve a good rating overall.

Why we inspected

We had concerns in relation to some complaints reported to us. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Hermitage charity Care Trust on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified multiple breaches in relation to the safe care and treatment of people, safeguarding people from abuse, notifying the CQC of particular incidents and the lack of quality monitoring systems in place.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.