5 December 2014
During an inspection looking at part of the service
At this inspection we found the provider had not made the necessary improvements. The assessment, planning and delivery of care did not meet people's individual needs, and service users were not protected against the risks of inappropriate and unsafe care.
We had not planned to look at the management of medicines at this inspection. However, while examining other areas of care delivery we found evidence that people were not protected against the risks associated with the unsafe use and management of medicines. These concerns were significant and indicated that the risks in this area had increased from our previous inspection.
As this was a targeted inspection to follow up on specific areas of concern, we did not consider all of the five key questions that we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Instead, we concentrated on whether the service was safe.
Is the service safe?
We found the service was not safe.
People's risks were not always assessed and care was not always planned and delivered to meet their needs.
People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. We identified concerns in relation to the obtaining, handling, administration, recording and safe storage of medicines.
People who had been identified as being at high risk of pressure sores did not receive care in line with their needs and were put at avoidable risk. People were not supported to change position to reduce the risks of developing pressure sores.
Assessments regarding eating and drinking were not always followed which put people at risk of choking and dehydration.
People's welfare needs were not met as they were not supported to take part in activities of their own choosing or in line with their known interests. Steps had not been taken to ensure people received sufficient interaction to meet their social needs. The failure to plan and provide activities in line with people's known interests, preferences and assessed needs meant that people received inadequate mental and physical stimulation and insufficient social interaction.