29 May 2019
During a routine inspection
Enforcement: At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.
People’s experience of using this service:
People were not always kept safe because risks were not always assessed, monitored or mitigated. We received mixed views on staffing levels. People’s medicines were not consistently managed well. Accidents and incidents were not being consistently investigated and followed up. Where lessons could be learned to improve the service and make the care people received safer; these were not always identified and addressed. Staff described how they would keep people protected from potential harm and knew how to report allegations of poor practice
People received care and support from staff who had not always completed key and specialist training to meet people’s individual needs. People told us that staff sought their permission before providing care and support. However, we identified that the registered provider had not consistently understood their obligations under the Mental Capacity Act (2005). People told us they enjoyed their meals and they chose what they preferred. People were supported to meet their health care needs, when necessary.
People were supported by kind and caring staff that knew them well. Staff protected people's privacy and dignity when supporting people. People were supported to be as independent as possible.
People’s care plans were person centred and staff told us they worked hard to ensure people were supported as individuals. People and their relatives knew who to contact if they had any complaints.
The provider had some systems in place to enable them to assess and monitor the quality of the service provided, but these systems were not being used effectively to manage all aspects of the service. The quality monitoring and assurance processes were not effective in ensuring that the risks to people's health and safety were appropriately assessed, monitored and mitigated.
Rating at last inspection: The service was rated Good overall. Our last report was published on 22 October 2016.
Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up: 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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk