29 November 2017
During a routine inspection
Moseley Gardens provides accommodation and personal care for up to eight people who require specialist support relating to their learning disabilities and/or mental health needs. At the time of our inspection, there were six people living at the home. At the last inspection that service was rated as requires improvement; sufficient improvements had not been made and a further deterioration was noted.
The provider was required to deploy a Registered Manager to manage the service as part of the conditions of their registration. There had not been a registered manager in post since August 2017. The provider had appointed a new manager who had been managing the day to day running of the service since October 2017 and they were applying for their registration with us. 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.
The service was not always safe because the provider had not always ensured that there were sufficient numbers of staff available to meet peoples’ needs in a safe way both in and outside of the home. Staff were not always aware of people’s personal histories and therefore were not aware of some of the risks associated with their support needs. This meant that people, staff, visitors and the general public were put at risk of actual or potential avoidable harm. The home environment did not always promote comfort or safety; it was not always clean or well-maintained. The provider’s quality monitoring systems and processes had been ineffective in identifying some of the shortfalls found during the inspection. Where quality assurance processes had identified areas in need of improvement, the provider had not always responded efficiently to ensure the safety and quality of the service was maintained in a timely manner.
Staff received training relevant to their role but it was not always evident how they transferred their learning in to practice. People were not always cared for in the least restrictive ways possible and the provider was not always responsive to their feedback. This meant that people’s views and opinions were not always listened to or valued and people were not consistently treated with dignity and respect.
The provider did not use communication aids to enable people to fully engage within the planning or review of their care or to influence the development of the service. People were supported to engage in some activities of interest but there were missed opportunities by staff to interact with people in a meaningful way. This meant that care was not always provided in keeping with quality standards set for services that support people with learning disabilities.
People were supported to maintain good health because the provider worked collaboratively with other agencies. However, this was not always by way of a proactive approach. People were encouraged to develop and maintain their independence as far as reasonably possible and were supported to sustain relationships with people that were important to them. Visitors were welcome at any time.
This meant we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; regulation 12 associated with safe care and treatment and regulation 17 concerning the governance of the service. You can see what action we told the provider to take at the back of the full version of the report.
The overall rating for this service is ‘Inadequate’ and the service is therefore 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 has been made within this timeframe and we continue to find 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 of our return visit if they do not improve. After which, this service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will then be conducted within a further six months, and if there is still not enough improvement and an on-going rating of inadequate is awarded for any key question or overall, we will take further 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.