29 November 2016
During a routine inspection
There was a registered manager in post. 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.
At this inspection we found that the provider had failed to ensure that previous improvements had been sustained. We found that there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of this report.
Medicines were not managed appropriately and safely. People did not always get their medicines as prescribed.
Staff were kind to people when they were providing support. People did not consistently have their privacy and dignity considered. We have made a recommendation about privacy and dignity. Staff were able to tell us about people’s needs. Staff knew how to safeguard people against abuse.
We found that people’s health care needs were assessed. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals.
Staff were provided with training on core areas and training in areas specific to the needs of people who lived at the home such as care of people living with dementia. The provider had a training plan in place and staff had received supervision.
The provider did not always act in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.
People had their nutritional needs assessed but were not always supported to eat their meals to keep them healthy. Where people had special dietary requirements we saw that these were provided for.
People had access to limited activities. Signage in the home was poor and not provided in a manner which assisted people with dementia to orientate themselves to their surroundings.
Records were not accurate. Care plans were not updated consistently and did not reflect the care people required.
Systems were not in place to adequately assess, monitor and improve the quality and safety of the services. Audits were in place for areas such as medicines and infection control however they had not consistently improved the quality of care. Accidents and incidents were recorded.
Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns.
The provider had informed us of notifications as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.