This inspection took place on 5 February 2016 and was unannounced. This was the first inspection at the home.88 Abbey Wood Road is a care home which provides care and support for up to seven people with mild/moderate learning disabilities. There were five people using the service at the time of our inspection.
There was a new manager, who has applied to be the registered manager, in place since two days prior to the inspection in February 2016. 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 this inspection we found a number of breaches of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014.
People’s safety had been compromised in that medicines were not managed safely. Risks to people had not always been identified or properly assessed, and action had not always been taken to manage risks safely. CQC is considering the appropriate regulatory response to resolve the problems we found. We will report on any action taken when it is completed.
Systems were not in place to monitor and evaluate the quality and safety of the service and regular feedback was not sought from people who used the service, relatives, staff or health care professionals in order to improve the service. CQC is considering the appropriate regulatory response to resolve the problems we found and will report on any action taken when it is completed.
Staff had not received up to date refresher training. Staff had not received appropriate support through formal supervisions. You can see what action we have told the provider to take at the back of the full version of this report.
Appropriate recruitment checks took place before staff started work. There were enough staff to meet people’s need. Safeguarding adults procedures were robust and staff understood how to protect the people they supported from the risk of abuse. The service had a whistle-blowing procedure which was available to staff, and staff said they would use it if they needed to.
People, their relatives and healthcare professionals were involved in their care planning. Support plans provided some information and guidance for staff on how to support people using the service. However, improvement was required because they had not always been updated to reflect people’s changing preferences. People had access to a range of healthcare professionals when required. People were supported to have a healthy and balanced diet.
The manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff treated people with kindness and compassion; while respecting their privacy and dignity. Each person had a key worker assigned to them to give individual and focused support. Staff knew people well and remembered things that were important to them so that they received person-centred care.
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 consider the process of preventing the provider from operating this service. This may 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 and there is still a rating of inadequate for any key question or overall, we may take action to prevent the provider from operating this service. This may 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.