About the service Bethel/Bethesda is a residential care home providing personal care to 22 people aged 65 and over at the time of the inspection. The service can support up to 34 people.
The service is in one building which had been divided into two sides. One side is known as Bethel, and the other Bethesda. All people living at the service have their own bedrooms. Some people had a sink in their bedrooms, while others had a sink and a toilet. Bethel and Bethesda each have shared bath/shower room, a dining room and lounge area. There is not a garden, but there is a courtyard which people could access.
People’s experience of using this service and what we found
People living at the service were not safe. Not everyone had their care needs and associated risks assessed. This meant staff were not aware of how to safely care for people and to minimise risks people were exposed to.
Staff failed to wear personal protective equipment (PPE) in accordance with government guidelines. During our inspection, staff were observed warning others to put face masks on as CQC were inspecting in the building.
Maintenance checks were completed but staff failed to risk assess equipment before it was used. This meant people living at the service were not exposed to unnecessary risks of harm.
The service was not well-led. The registered manager and nominated individual did not have oversight of the service. Governance systems and processes were not in place to ensure care was safe, and opportunities to improve the service were missed.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
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 good (published 30 June 2019).
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We received concerns in relation to staff not wearing PPE and regarding the safety of the environment. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bethel/Bethesda on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to providing safe care and treatment to people living at the service; the safety of the environment; and how the service was led and governed at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.