Archived: Haslington Residential Home

Updated 5 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection, which took place on 19 June 2018 and was unannounced.

The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using similar services or caring for older family members.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information including the Provider Information Return to plan our inspection.

Some people were unable to tell us about their experiences, so we observed care and support in communal areas. We spoke with ten people who used the service. We also spoke with five visiting relatives.

We spoke with five care staff, two senior care staff, one cook and the registered provider.

We looked at the provider’s records. These included five people’s care records, which included care plans, health records, risk assessments and daily care records. We looked at six staff files, a sample of audits, satisfaction surveys, and policies and procedures.

We asked the registered provider to send additional information after the inspection visit, including staff recruitment related records and care related information.

The information we requested was sent to us in a timely manner.

Updated 5 September 2018

The inspection was carried out on 19 June 2018, and was unannounced.

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

Haslington is a two storey large Victorian house. Haslington can accommodate up to 46 people who require nursing or personal care and who are living with dementia. People's bedrooms are provided over three floors, with a passenger lift in-between. The three floors are for people with different dependency levels. The top floor is considered medium dependency, the middle floor is considered high dependency and the ground floor is considered low dependency. There are 31 people at the home at the time of the inspection. Both men and women live in the home. Some people are not able to verbally communicate their feedback and experiences of living in the home.

At our previous inspection on 24 and 25 January 2017, we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to ensuring that effective systems were in place to monitor the quality of the service and meeting people's needs and preferences to provide consistent care. Quality audit systems were not completely robust in identifying all shortfalls within the service and ensuring that any shortfalls identified were fully rectified. Activities were being provided but people and relatives told us that this was an area that still required improvement. Available activities were not being consistently communicated to people.

We asked the registered provider to take action to meet the regulations. We received an action plan on 3 April 2017, which stated that the registered provider would take action to become compliant with the regulations by the 10 July 2017. Improvements had been made in relation to meeting Regulation 12. However, further improvements were still required in relation to Regulation 17.

At this inspection, we found the service ‘Inadequate’ and the service is therefore in ‘special measures.’

At the time of this inspection, the service was being managed by the registered provider. The registered manager had been off sick since 12 January 2018. The registered provider failed to notify CQC of the absence of the registered manager within the required timescale of 28 days. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the home. 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 home is run.

People's needs had been assessed. However, care plans did not have appropriate risk assessments that were specific to people's needs that would give staff appropriate guidance. Specific guidance documents about how to manage epileptic seizures, challenging behaviour and skin integrity were not provided for staff. Care plans were not detailed and did not meet people’s needs in a person centred way. The registered provider had not responded to changes in people’s needs quickly or appropriately.

People are not supported to have maximum choice and control of their lives and staff do not support them in the least restrictive way possible; the policies and systems in the service do not support this practice.

There were no effective quality audit systems in place to enable the registered provider to assess, monitor and improve the quality and safety of the service.

There were limited activities located around the service for people to be engaged with. Not everyone was engaged in activities during our inspection. People told us they were bored and relatives were not satisfied with activities in the service. We made a recommendation about this.

There appeared to be enough staff to support people, but they were not appropriately deployed. We observed that staff were visibly present and providing support and assistance on the middle floor. On the top floor, however, we observed that there were periods when people were completely unattended to by staff. We have made a recommendation about this.

Staff showed they were caring. However, we observed that people’s privacy and dignity was not always respected.

People were safe from the risk of abuse at Haslington Residential Home. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. Staff recognised the signs of abuse and what to look out for. There were systems in place to support staff and people to stay safe. Medicines were managed safely and people received them as prescribed.

People were supported by staff that had been recruited safely and had checks undertaken to ensure they were suitable for their role. Staff received regular training and supervision to help them meet people's needs.

The registered provider ensured the complaints procedure was made available if people wished to make a complaint. People, relatives and staff told us that the registered provider was approachable.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.