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The provider had asked for feedback of the service from people and relatives. There was no evidence that the comments made had been listened to and actioned. During this inspection we found three breaches of the Health and Social Care Act Regulations. You can see what action we told the provider to take at the back of the full version of this report.
During this inspection we found one breach of the Health and Social Care Act Regulations. The provider had displayed the ratings from the last inspection, in February 2018, in a prominent place so that people and their visitors were able to see them. At the last inspection, we found the support of people’s rights within the basic principles of the Mental Capacity Act 2005 needed to be improved.
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When a complaint had been received, the provider had investigated and responded to the complainant in line with their policy. The Care Quality Commission is the official regulator for the care sector. They inspect care homes and care services to make sure they are safe, caring, effective, responsive and well-led. Autumna is the UK's largest and most comprehensive later-life living & elderly care directory. Our website is free to use, we are proudly independent, and we never take referral fees. The provider sent the CQC an action plan which described how and when the improvements would be made.
However, people we spoke with told us they were not involved in their care planning. Two relatives told us they had not been asked for their views concerning what should be included in the care plan for their family member. We were told there was no service user guide in place or information that was given to people when they moved into the home.
Dale Lodge
People waited too long for care they needed at lunchtime due to the level of staffing. People were not fully protected from the risk of abuse because staff did not have access to information they could refer to. There were assessments undertaken on admission and the care plans had been developed and drawn up with the individual, where possible, and their family had been consulted on aspects of the care plan. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action.
They wrote to us on 18 December 2013 and stated that all records apart from staff files were kept in the nurse's office. However, during our inspection of 22 April 2014 we found that a number of records could not be located promptly as the provider unavailable. Staff had a safeguarding procedure to access the information they needed to protect people and raise concerns. A copy of the local authority procedure with their full guidance for reporting concerns was kept in the home, however, it was an old copy with the wrong information available. The provider had not displayed the ratings of the previous inspection in a prominent place as required by the regulations. New staff had not had the appropriate checks made of their suitability to care for and support the people living in the home.
Reviews
The care home caters for younger and elderly adults with sensory impairment. The nursing home also cares for residents with dementia and mental health conditions. The provider and registered manager sent action plans dated 27 April 2018 stating they had already made the improvements to make sure regulations 12 and 19 were met. At this inspection, the provider and registered manager had made improvements in most areas. People’s prescribed medicines were now being managed and administered safely.
People’s interests were taken into account and catered for on an individual basis. During this inspection, people were not left unattended for long periods of time. People were supported to maintain their independence to help to keep them active.
We have identified this as an area of practice that needs improvement and have made a recommendation about the monitoring and oversight of air mattresses. The premises were clean and suitably maintained and equipment and utilities had been serviced. However, fire evacuation guidance did not give the specific information required to keep people safe.
However the registered manager has failed to notify CQC of the authorisations. Staff had completed training in the Mental Capacity Act 2005 but there was no evidence that this training had been embedded in every day practice of caring for people. Staff had not received training in Deprivation of Liberty Safeguards . Staff were receiving supervision but not in line with the provider’s policy.
Abbeyfield Deneholm House
They confirmed that they had a choice of food for all meals. We found that records were not accessible and that we could not check to see if the registered person was managing the delivery of the regulated activity safely. There were ‘residents meetings’ held which all people were encouraged to attend.People had been consulted about recent redecoration works and chosen colours.
The manager said the home was looking to recruit an activities coordinator, but nothing had been put in place. At other times we offer an answer phone service so please leave a message and we'll call you back. There is chicken casserole and mash, or cheese omelette and chips today”.
Wombwell Hall Care Home
There was no oversight of what training needed to be completed and when it should be completed. We looked at care plans and found that these contained information staff would need to know to be able to support a person’s needs. People had personal evacuation plans and staff had received fire training and knew how to support people to evacuate the building in an emergency. At the last inspection we found breaches of Regulations 12, 18 and 19 of the Health and Social Care Act Regulations 2014. We set out to answer our five questions; Is the service caring? The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.
The provider had notified CQC of important events as required. The improvements related to Regulation 16 of the Health and Social Care Act Regulations 2014 and Regulation 18 of the Care Quality Commission Regulations 2009. However many improvements had not been made and we found continuing breaches of regulations from the last inspection. These related to Regulation 9, 11, 12, 17 and 18 of the Health and Social Care Act Regulations 2014. The inspection was unannounced.Ashley Down Nursing Home is a ‘care home’. There were 13 people living at the service at the time of our inspection.
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This meant that people had not been consulted and their views had not been taken into account concerning how they wanted their care delivered. We have asked the provider to tell us what improvements they will make to ensure people are involved in their care. People’s care plans were suitable for their personal care and nursing needs. However, care plans were not person centred and there was no focus on people’s well-being, social and cultural needs based on their preferences and interests. People and their relatives were not involved in reviewing their care plans. Risk assessments around people’s personal and nursing care needs were in place.
There was a lack of oversight of the quality of service and there was no plan to drive improvements. The previous six inspections identified significant concerns. The provider did not take any responsibility or ownership or give any assurances that immediate action would be taken to address CQC’s concerns at this inspection. The provider and manager did not work cohesively to implement changes and they did not lead by example. People’s needs had been assessed and this had been used to consistently make sure enough staff were on duty to provide safe, effective and responsive care. Staff had time to spend supporting people in a meaningful way that respected individual needs.
We have identified this as an area of practice that needs improvement and have made a recommendation about the monitoring and oversight of air mattresses. The premises were clean and suitably maintained and equipment and utilities had been serviced. However, fire evacuation guidance did not give the specific information required to keep people safe.
DMC Consulting Services – Gravesend
People thought they were listened to and were involved in their care and how this was delivered. Some concerns were found around maintaining people’s privacy and dignity, however, this was not a wider issue. People and their relatives told us their privacy was respected by staff.
At the last inspection on 22 April 2014 we identified breaches in the regulations of the Health and Social Care Act Regulations 2010. People weren’t given the information they needed in a suitable format. People or their relatives had not been involved in planning or reviewing their own care. Meetings had not been held to assess people’s capacity to make decisions where these had been needed. The premises were not secure and equipment had not been safely maintained. Arrangements for keeping people safe in the event of an emergency were not in place.
'I experienced Christmas party season outside Kent's 'rowdiest' McDonald's'
We contacted the local fire and rescue service who attended the service and instructed the provider to take steps to keep people safe. The service was clean; however, areas of the service had been affected by leaks and there was no maintenance plan to rectify this or redecorate the rooms. Edward Moore House is a purpose built residential care home situated in Gravesend. The home provides care for up to 39 older people living with frailty or dementia. General wellbeing checks were recorded by staff at regular intervals. People were referred to healthcare professionals when needed.
Recruitment procedures were followed including checking references and criminal records. Staff had the training and experience to support people and meet their needs. Systems in place to assess the quality of the service provided were not always effective and had not consistently identified shortfalls in the provision of care and quality.
Inadequate
Some staff told us that the manager was approachable and that they felt supported. We asked the provider to take action to meet regulations 9, 11 and 16. We also asked the provider to take action to meet Regulation 18 of the Care Quality Commission Regulations 2009. We took enforcement action against the provider and told them to meet Regulation 12 by 30 March 2017, Regulation 17 by 28 April 2017 and Regulation 18 by 31 January 2017.
Large gaps in documentation reflected that people could go up to seven hours without support to meet their continence needs. Staff told us they received essential training that equipped them with the skills to meet people’s individual care needs. The provider had failed to identify that training had not been provided on the safe and effective management of diabetes, epilepsy and pressure care.
Copperfields Residential Home
We talked with people who used the service or their relatives and we were told by three people that there were not always enough staff at the home. One person told us that they do not always get two staff to carry out manual handling operations when this is a requirement in their care plan. People we spoke with were positive about the support given to them by members of the staff team. However, we observed that people sometimes had to wait for their needs to be met as staff were busy providing support for other people.
All staff were trained in the principles of the MCA and the DoLS and were knowledgeable about the requirements of the legislation. “We are having a garden party with a barbeque on Saturday – that will be a good time”. If you wish to see the evidence supporting our summary please read the full report. We will minimize, reuse and reuse all materials wherever possible. Our toner and ink cartridges are recycled using the manufacturer\'s recycling services. If you got here via a search engine like Google, then the page did exist on this site at some point, so you're on the right track.
Mayflower Care Centre
“We have lots of different activities in the afternoons, exercises, ball and balloon games, dominoes, darts, singing and things”. “We mostly sit and chat together in the mornings and watch TV, and sometimes we run out of things to say”. We also talked with the five staff members who were on duty in the morning; and briefly met other staff who came on duty during the afternoon. The security of the home had been improved as well as the surrounding perimeter of the garden.
Staff had received training in safeguarding and were able to describe what they would do in the event of any safeguarding issues occurring. Staff knew about the whistle blowing policy, why and how to use it. However, one person was still waiting to receive support with the issues they had raised. People had opportunities to feedback about their care and support. However ‘Resident’s survey’s’ showed that specific requests had not been responded to.
We found that the registered person was not making suitable arrangements to ensure that people who used the service were safeguarded from abuse. We talked with people who used the service or their relatives, one person said “staff treat me with respect, I get on very well with staff” another said “I like my room and the staff are lovely”. We saw that people who used wheelchairs or who needed support to get to the dining room were left in the dining room for 45 minutes after they had finished their meals. One person said, “We wait too long in the dining room” This meant that the registered person was not respecting people’s dignity.
People’s health needs were generally taken care of by the registered nurses working in the home and GP practices. Health referrals had been made, however not always suitably quickly and not always pursued and followed up. Where people required a special diet or consistency of food this was documented and appropriate advice and guidance had been sought. The provider had now displayed the ratings from the last inspection in July 2017 in a prominent place so that people and their visitors were able to see them. People and their relatives gave positive feedback about the kind and caring nature of the staff team. Staff knew people well and a friendly and more relaxed atmosphere was evident.
