Updated 9 September 2024
This inspection was prompted by concerns raised with us by a relative of someone using the service. Inspection visits took place on 17 and 25 September 2024. At this inspection we found the service needed to make significant improvements. We found breaches in regulations linked to safe care and treatment, safeguarding, meeting nutritional needs and good governance. People were exposed to the risk of harm because the service failed to identify, manage and plan for risks effectively. Safe systems to manage people’s medicines were not in place. People were not protected from the risk of abuse because the service failed to operate systems which identified and investigated potential abuse. The service failed to ensure people’s nutritional and hydration needs were consistently met, and this placed people at risk of malnutrition. The management and provider oversight of the quality and safety of the care provided was insufficient. Effective systems were not always in place to monitor, identify and act upon areas for improvement.