Archived: 148 Hornsey Lane

Updated 5 January 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

This was a focused inspection to check whether the provider had met the requirements of the Warning Notice in relation to regulation 12 (Safe care and treatment) as well as to examine if improvements had been made following other breaches of regulations 12, 17 and 18.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

This inspection took place on 2 November 2021 and was unannounced.

Inspection team

This inspection was carried out by one inspector and an expert by experience made phone calls to one person using the service and six relatives.

Service and service type

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

The service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete the Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

We reviewed information we had received about the service since the last inspection.

During the inspection

During our visit, we spoke with two people who used the service. We also spoke with the registered manager, the Head of Service for people with a learning disability, London and South Essex, one senior support worker and one staff member. We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed. We also had feedback from three professionals who had contact with the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 5 January 2022

About the service

148 Hornsey Lane provides accommodation and personal care to people with long-term mental health needs. The service accommodates 12 people across three floors. At the time of our inspection there were 11 people using the service.

People’s experience of using this service and what we found

During this inspection we found that the management team needed to improve the oversight of the service provision. The provider needed to ensure that all aspects of the service were regularly and effectively monitored and that the service was provided in line with the current government guidelines and legislation.

We found improvements had been made in relation to the infection prevention and control, risk assessment, management of medicines and staffing. There remained some areas of improvement still to be achieved in seeking feedback from people and relatives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives said people usually felt happy and safe at the service. We received concerns about how safe the home was in keeping people safe for visitors bringing in COVID-19 and how much information was shared with relatives. External health and social care professionals said that staffing had been a concern due to staff turnover and that some people’s mental health should be able to be responded to in house rather than seeking community mental health colleague’s advice.

The recruitment procedures for staff employed directly by the provider, and from external staff agencies were now safe as, not least for externally recruited staff, the provider was verifying staff background checks. Staff we spoke with understood their role in safeguarding people from harm from others. There were appropriate accidents and incidents procedures in place.

The registered manager understood their legal responsibility around being open and honest with people when something goes wrong and notifying the CQC about significant events at the service. However, we were concerned that a significant event that had happened a few days prior to our visit was not mentioned to us when we were at the home. This had been raised by a senior manager the following day and CQC had been notified via CQC’s notification system.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 8 January 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve to comply with a warning notice. The warning notice had been issued in relation to infection prevention and control. Our previous inspection also found breaches of regulation 12 in respect of risk assessments, fire safety and medicines. There were also breaches of regulation 17 regarding good governance and regulation 18 in respect of staffing.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations and had complied with the warning notice.

Why we inspected

The inspection was prompted to follow up on compliance with the warning notice that had been issued after our inspection in November 2020. A decision was made for us to inspect and examine this and the previous breaches of regulation.

The inspection was prompted in part due to concerns received about protecting people from COVID-19, information sharing, treating people with dignity and respect, staff turnover and managing people’s mental health issues. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider had made improvements but they also acknowledged that more could be done.

The overall rating for the service has not changed from requires improvement. This is based on the findings at this inspection.

Follow up

We will work alongside the provider and local authority to monitor progress.