This inspection took place on 9 March 2014 and was unannounced.
College Road Care Home provides accommodation and personal care for a maximum of three people with learning disabilities. There were two people using the service on the day of our inspection. At our last inspection in October 2013 the service was compliant with all the regulations we looked at.
The service had a registered manager. 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 and associated Regulations about how the service is run.
Although people’s records showed that they had access to healthcare professionals, the provider did not always ensure people received coordinated care with other services involved in people’s care.
Care plans and risk assessments were not always updated following reviews or when there was a change in people’s needs. This meant staff did not always have an accurate care plan record to ensure they had information about how to meet the person’s individual care needs.
Senior management and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). However, the care files did not have adequate assessments of people’s mental capacity to make decisions about their care or treatment. In addition, there was not an effective system in place to prevent people being unnecessarily deprived of their liberty. For example, the provider had not made an application under DoLS for people living at the home, even though their liberty may have been restricted.
There were limited systems in place for staff to discuss issues and influence the operation of the home. The provider did not have regular meetings with people, relatives and staff, including surveys to gather their views about the quality of the service.
The provider did not have a robust recruitment policy that covered employing ex-offenders. There was no guidance to follow in relation to managing job applications involving ex-offenders. This meant that people could be at potential risk of receiving care from staff that may be unsuitable to work with vulnerable adults.
The provider did not have an effective process of monitoring quality. We found that the provider had not picked up on risks to people’s safety and welfare that we had identified during our visit.
We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
The provider did not ensure the recruitment practices always ensured people were protected from staff unsuitable to work with vulnerable people. This was a breach of Regulation 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The registered provider did not have suitable arrangements in place for obtaining, and acting with, the consent of service users in relation to the care and treatment provided for them. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The registered person did not have suitable arrangements to ensure staff were appropriately supported by receiving supervision and appraisal. This was a breach of Regulation 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The registered person had not taken proper steps to ensure that each person was protected against the risks of receiving inappropriate care and treatment because the provider did not always plan and deliver the service in a way to meet individual needs. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The registered person had not protected people against the risks of inappropriate or unsafe care by means of the effective operation of systems to assess and monitor the quality of services provided. This was a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We also made recommendations in relation to coordination of care between services, people’s involvement in their care, meeting people’s communication needs and in respect of supporting people when they wanted to make complains about care.