Table of Content
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.
“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.
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