Archived: Dick O'th Banks Road

Updated 26 June 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 inspection took place on 25 April 2018 and was unannounced. The inspection continued on 27 April 2018 and was announced. The inspection was undertaken by one inspector.

Prior to the inspection we reviewed the information we held about the service, including statutory notifications submitted about key events that occurred at the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

People using the service were unable to speak with us, therefore we observed interactions between staff and people using the service. We spoke with the manager, operations manager, team leader, and six members of care staff. We also spoke with one relative, three health professionals, and gained information by email from a further two health professionals.

We looked at care documentation relating to two people, one person’s medicines administration records, four staff personnel files, staff training records and records relating to the management of the service including quality audits.

Updated 26 June 2018

At the time of the inspection there was a manager in post who was registering to become the registered manager. 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 inspection in March 2016, the service was rated Good. At this inspection we found the service Required Improvement.

We were unable to speak to people to ascertain their views as to the approach of staff in caring for them due to their limited verbal communication skills. We spent time observing interactions between staff and found staff to be friendly and kind in their approach towards people.

People were supported by staff they knew well and trusted. However they did not have maximum choice and control of their lives and therefore were not supported in the least restrictive way possible. People did not always receive care that was responsive to their needs and improvements were required to the home’s approach to person centred care.

People were living with a learning disability, autism or had needs relating to their mental health, which affected their ability to make some decisions about their care and support. Staff showed a good understanding of the Mental Capacity Act 2005 (MCA) and their role in supporting people’s rights to make their own decisions. However they required more training and support to meet people’s communication needs.

Care plans were personalised and evidenced how people would like to receive their care, however information held within the care plans was out of date. At the time of the inspection reviews were taking place, which meant care plans would be updated and transferred to the providers on line monitoring system.

Staff understood their responsibilities with regard to reporting suspected abuse in order to safeguard people from harm. Guidelines were followed by staff to minimise the risk of harm to people and minimise re occurrences of any incidents. However there were not enough staff to minimise risk.

There were not enough staff to support people that presented a risk to themselves and others. There were not enough staff to provide meaningful activities for people and to be supported to pursue individual interests. Recruitment checks were completed to assess the suitability of the staff employed.

People had their medicines ordered, stored, administered and recorded safely. All staff received medicine administration training and had to be assessed as competent before they were allowed to administer people’s medicines. People were supported by staff to attend medical appointments.

Staff told us the majority of the cleaning duties took place each night. However cleaning records showed this was not done consistently. Staff had completed infection control training. When things went wrong lessons were learnt and actions put in place to improve safety.

Systems and processes were in place that monitored the quality of the service. However these audits were not fully effective at identifying the shortfalls in the service we found during our inspection. Systems and processes had not identified people were at risk of social isolation or having appropriate support to meet their communication needs or information in records were out of date.

Arrangements for oversight of the service required improvement to identify and respond to concerns and risks. The new manager was also under a new management structure. There were planned changes to the registration of the service and staff told us they were aware of changes to the service and were awaiting training on how to deliver support under the new registration of supported living.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read at the back of the full report what action we have told the provider to take.