20 October 2015
During a routine inspection
This was an unannounced inspection carried out on the 20 October 2015.
Beenstock Home Management Co Limited, is a domiciliary care agency which provides personal care services, exclusively to members of the Orthodox Jewish community who live in a sheltered housing scheme. Accommodation consists of self-contained flats located within a registered care home for older people known as Beenstock Home. A number of facilities provided by Beenstock Home is also available for the use by tenants of the scheme and includes dining facilities and participation in organised activities.
There was no 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 spoke to the registered manager of Beenstock Home, who explained that due to a misunderstanding between the service and CQC Registration, an error in registering the manager had occurred. The service have since submitted an application to combine the registration of Beenstock Home and Beenstock Home Management Co. Ltd, which is currently being addressed.
When we last inspected this service in May 2014, we did not identify any concerns about the service.
During this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.
We found the service undertook checks to monitor the quality service delivery. These included weekly medication record chart audits, however the last audit had been conducted on 26 September 2015. We looked at an Independent Monthly Home Audit, where records indicated the last audit had taken place in May 2015. Though care files were audited, the service had failed to identify missing risk assessments, which were identified as part of this inspection.
This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, good governance, because the service failed to assess and monitor the quality of service provision effectively.
People who used the service told us they felt safe, as did their relatives.
We found the service had suitable safeguarding procedures in place, which were designed to protect vulnerable people from abuse and the risk of abuse.
People were protected against the risks of abuse because the service had appropriate recruitment procedures in place. Appropriate checks were carried out before staff began work with the service to ensure they were fit to work with vulnerable adults.
We looked at how the service managed people’s medicines and found that suitable arrangements were in place to ensure the service administered medicines safely.
As part of this inspection we looked at the training staff received to ensure they were fully supported and qualified to undertake their roles. Staff we spoke with confirmed they received training both at induction and then annually through refresher training. They also have opportunities to attend other non-mandatory courses.
We found that before any care was provided, the service obtained written consent from the person who used the service or their representative. We were able to verify this by speaking to people and from reviewing care files.
People who used this service could choose whether to have meals in the dining room with residents from the care home or in their own flats. We spent time observing the lunch period to see how people were supported to receive adequate nutrition and hydration.
People we spoke with told us that the service was excellent and that staff were kind and caring.
People who used the service told us that they were treated with dignity and respect by staff.
People told us that staff helped them retain their independence. Staff we spoke with were clear about how to promote people’s independence.
The service ensured that staff effectively met the cultural and spiritual wellbeing of people who used the service.
We found the service had systems in place to routinely listen to people’s experience, concerns and complaints.
People who used the service were able to access a range of activities available on a daily basis.
We looked at a sample of six care files to understand how the service delivered personalised care that was responsive to people’s needs. We found that before people started using the service, a pre-assessment of need was carried out by the service, which included current diagnosis, medication, personal hygiene and continence.
We found that the management promoted an open and transparent culture amongst staff. Staff we spoke with were positive about the leadership provided by the service.
We found the provider was unable to demonstrate to us that the installation of the CCTV system had been installed in the best interests of people who used the service and that tenants, including people who lacked capacity had been effectively consulted.
Providers are required by law to notify CQC of certain events in the service such as serious injuries and deaths. Records we looked at confirmed that CQC had received all the required notifications in a timely way from the service.