About the service:
Belper Views Residential Care Home is a care home that provides personal care for up to 25 people, some of whom are living with dementia. At the time of the inspection there were 23 people using the service. The accommodation is split across two floors. The ground floor provides communal space with two lounges, a dining area, conservatory and level access to a secure gardens There are bedrooms, toilets and bathing facilities on both floors.
People’s experience of using this service:
The overall rating for the service is inadequate and the service will be placed in special measures.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.
After the last inspection the provider had developed an action plan, however we found that the actions agreed to be completed by the provider and registered manager had not been done.
There was a lack of leadership, coordination and oversight which failed to drive the necessary improvement. We saw that audits had not been used to consider how the safety for people could be improved and risks reduced or mitigated. The rating from the last inspection was not displayed.
Staff did not receive the support they required to ensure they were competent in their roles. When they completed training, their knowledge was not checked to see if they understood how to implement their learning. Staff were not always responsive to people’s needs and we saw that the communal areas were frequently unsupervised. Lessons had not been learnt to drive improvements.
People were not safe and staff were not aware of how to raise concerns and we saw incidents which had occurred had not been reported. People’s risks had not been considered and measures put in place to reduce the risks.
Medicines were not managed safely. People had not always received their prescribed medicines, and stocks had not been regularly checked to ensure it was stored in accordance with guidance. When staff administered the medicine, they did not follow the national guidance and we saw this placed people at risk of not receiving their medicines.
People were not protected from the risk of infection. Measures were not in place to ensure cleaning schedules had been followed, to maintain cleanliness and hygiene at the home. People’s needs and choices had not been considered.
People are not supported to have maximum choice and control of their lives and staff had not supported them in the least restrictive way possible; the policies and systems in the service did not supported this practice.
People enjoyed the meals, however they did not always receive the support they required during the meal period. When people required support with their nutrition this had not been considered or a referral made to a health care professional for direction.
When people required support with their health care, referrals had not been made in a timely way to support people’s immediate or ongoing needs. This meant effective partnership working had not been developed for people’s care when needed..
The home had not considered people’s view when they embarked on a refurbishment of the home. No questionnaire or meeting had been held for people to comment on their care or the environment they lived in. People’s dignity was not always respected, we saw that staff did not always have the time to spend meaningful time with them.
People had not received a pre- assessment before they commenced their care at the home. There was not always care plans in place which detailed the care people required and their preferences.
Consideration had not been made in respect of information access or aspects of people’s equality or cultural needs. When people required support for their care at the end of their lives, this was not reflected in the care plans or the support which was available.
There had been no complaints made about the service since our last inspection, however there was no information to inform people how they could raise any concerns. When significant events had occurred at the home, notifications had not been completed to inform us of the event and the action which had been taken, to help us check people’s care at the service.
When staff were recruited this was done in line with current guidelines, obtaining two references and a police check. This ensures staff are safe to work with people.
Rating at last inspection: Rated as Requires Improvement, report published 25 July 2018
Why we inspected: This was a planned inspection based on the rating at the last inspection which was Requires Improvement. At this inspection we found the service had deteriorated to Inadequate and we have placed the home in special measures.
Enforcement We found eight breaches in regulatory requirements. You can see the action we asked the provider to take at the end of the 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: Immediately after our inspection, we wrote to the provider and asked them to take urgent action to address the most serious risks outlined in this report. In response, the provider developed an action plan detailing actions taken and planned, to make improvements and reduce risk. We have restricted admissions to the home and placed conditions on the home to support us to continue to monitor the progress being made.
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.