Background to this inspection
Updated
24 July 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Our inspection was carried out over two days on 15 and 18 May 2015. The inspection was unannounced and the inspection team consisted of two adult social care inspectors.
During our visit to the service we spoke with five people who used the service, two family members and seven staff. We also spoke with the manager, the provider and four visiting healthcare professionals. We looked at four people’s care records and observed how people were cared for. We toured the inside and outside of the premises including people’s bedrooms. We looked at staff records and records relating to the management of the service.
Before our inspection we reviewed the information we held about the service. We reviewed notifications of incidents that the provider had sent us since the last inspection and information we received from members of the public and local commissioners. Following the inspection we contacted a number of other health care professionals who visited people at the service.
Updated
24 July 2015
This was an unannounced inspection, carried out on 15 and 18 May 2015.
Deansgrove Residential Care Home is registered to provide accommodation and personal care. It is a privately owned care home which accommodates up to 29 adults. The service is located in the Huyton area of Knowsley and is close to local public transport routes. Accommodation is provided over two floors and the first floor can be accessed via a stair case or passenger lift. At the time of our inspection there were 16 people living at the home.
The service does not have a registered manager. 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. A manager had been appointed by the registered provider to manage the service.
At this inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The last inspection of Deansgrove Residential Care Home was carried out in November 2013 and we found that the service was meeting the regulations.
People who used the service were not fully protected from potential abuse. Staff did not have access to relevant safeguarding policies and procedures and their understanding about how to respond to allegations of abuse was limited. Incidents of potential abuse which had occurred at the service had not been appropriately dealt with. Staff did not have confidence in the provider’s whistleblowing policy and procedure. They told us they were afraid to raise any concerns they had with the manager.
People’s health and safety was put at risk because parts of the environment were unsafe and unclean and infection control practices were not being appropriately followed. Potential risks to people had not been considered or planned for in relation to their care.
People’s medication was not managed safely. Staff administered medication without appropriate guidance and there was excessive quantities of medication which could result in confusion and expired stock.
Training provided to staff was ineffective and some staff had not received training relevant to their roles and responsibilities. Staff did not have access to guidance such as codes of practice in relation to the work they carried out. Staff did not feel supported and they had not been given the opportunity to discuss their work, training and development needs.
The manager and staff had not completed training in relation to the Mental Capacity Act 2005 and they lacked knowledge in relation to this. They failed to apply the principles of the law when making decisions for people who lacked capacity and needed their liberty restricting for their safety.
There was no evidence to show that care plans were developed and reviewed with the involvement of the person they were for, and significant others, such as family members and health and social care professionals. Review records lacked detail about how the reviews took place, who was involved and the outcome.
People were not always respected because of the lack of maintenance and suitable facilities to ensure people’s privacy, dignity and independence. There was an unpleasant smell throughout the environment and people’s bed linen was tatty and faded. The storage of people’s personal records in communal areas undermined their privacy and confidentiality.
The leadership of the service was unsupportive and did not promote a culture whereby staff felt able to openly discuss any concerns they had. Systems were not in place to check on the quality of the service and ensure improvements were made. These included a lack of regular audits on aspects of the service and obtaining people’s views and opinions about the quality of the service.