We inspected the service on 23 February 2016. The inspection was unannounced. Queenswood provides accommodation for up to 41 older people. On the day of our inspection 40 people were using the service. The service had a registered manager in place at the time of our inspection. 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.
We carried out an unannounced inspection of this service on 14 April 2015. A breach of legal requirement was found in relation to having sufficient numbers of staff deployed in the service. We told the provider they must send us a written plan setting out how they would make the improvements and by when. The provider sent us an action plan on 28 July 2015 and told us they had made the improvements and complied with the regulation as of 22 July 2015.
We found that the registered manager had failed to make all of the improvements in relation to staffing levels in the service. Although the provider had increased the staffing levels at night, staff were not being deployed in a way which would ensure people received care and support in a timely way during the day. The dependency of people had not been assessed against the current staffing levels.
Medicines were not always managed safely to ensure people received their medicines as prescribed.
People were supported by staff who knew how to recognise abuse and how to respond to concerns. Risks in relation to people’s daily life were assessed and planned for to protect them from harm.
People were supported to make decisions, however where people did not have the capacity to make certain decisions, they were not fully protected under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support.
People were not always supported to maintain their nutrition and were not always supported with known risks relating to their health needs. Referrals were made to external professionals when people’s needs changed and people were supported to attend appointments.
People were treated with respect and cared for by staff who recognised the importance of spiritual and emotional wellbeing. People were involved in planning their care and support and were supported to live as independently as possible. People enjoyed an active social life and were supported to maintain and develop their hobbies and interests.
People may not be able to express themselves because the service did not have an open and inclusive culture. Systems in place to monitor and improve the quality of the service provided were not always effective in identifying and bringing about improvements needed. People were given the opportunity to have a say in how the service was run but when improvements or changes they suggested were made these were not always maintained.
You can see what action we told the provider to take at the back of the full version of the report.