This inspection took place on 23, 26 and 27 February 2015 and was unannounced. The service provides accommodation and care for up to 44 older people, including people living with dementia and mental health illness. There were 41 people living at the service when we visited. Accommodation is provided in two units with people requiring nursing care living on the ground floor. People living with dementia are accommodated on the first floor.
There was a registered manager who was responsible for the care of people. 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.
Prescribed creams and ointments were not managed safely putting people at risk of receiving creams which may have expired. There was a robust process which staff followed for disposal of medicines. Other medicines were managed and stored appropriately.
People were not protected against the risks associated with malnutrition due to a lack of assessments and action plan to manage such risks.
Care plans and assessments were not regularly reviewed including where people’s needs had changed. People were at risk of receiving inappropriate care as care plans did not contain up to date information to reflect people’s needs.
People were put at risk to their health through poor infection control processes. Staff did not follow the guidance on the prevention and control of infections and the associated risk of cross infection.
Staff did not receive support in the form of an organised programme of supervision and appraisal which conformed to the provider’s own procedures. Staff’s practices were not monitored in order to identify training and development needs.
There were not always adequate numbers of staff to meet the assessed needs of people safely and consistently.
The system for monitoring the quality of service provision and regular audits was not robust. This did not identify the issues we found with care planning, risk assessments, infection control and records.
There was a process that the staff followed if people needed to be deprived of their liberty. However the care plans did not all contain information about people’s ability to make decisions and whether assessments were done for particular decisions as needed as part of mental capacity act 2005.
People were satisfied with the food choices offered and the quality of the meals served. Where people had specific needs or preferences these were taken into account and staff were aware of them.
Recruitment procedures were followed and all necessary checks were completed prior to staff commencing work to minimise risk to people.
There were procedures for responding to complaints which were followed. A complaint log was maintained for recording complaints which included details of investigations and feedback to complainants.
We have made a recommendation about medicines management for the provider to consider when providing care to people.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This corresponds to breaches of the health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of the report