22 November 2023
During an inspection looking at part of the service
Saffron House is a care home supporting people across two floors of accommodation. The service is registered to provide care and accommodation for up to 48 younger and older people, people with physical disabilities and people living with dementia. At the time of our inspection there were 29 people using the service.
People’s experience of using this service and what we found
Staff did not consistently follow the provider's procedures for the safe storage, return and disposal of medicines. People's medicine records did not always evidence people had received their topical medicines as prescribed. People's care plans did not include robust guidance and information as to how staff should support a person when they became distressed. Risks around people's distress were not well managed as staff lacked the skills and knowledge to support people safely and effectively.
Systems and processes to ensure good oversight of the service were not being used effectively by the registered manager. Improvements driven by the provider had not been fully embedded in staff working practices. There was insufficient oversight and monitoring of staff to ensure people always received safe care.
Although some improvements had been made around the assessment of people's mental capacity, further improvements were required. People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not consistently support this practice.
The provider had made significant improvements to the environment to ensure people were protected from the risk of infections and some improvements were still in progress at the time of our inspection. However, we found improvements were still required around staff awareness of the risk of cross infection.
Most staff felt supported within their roles and told us they received regular supervision and meetings. Staff were recruited safely. Relatives did not always have confidence that staff received the clear direction and guidance they needed from the management of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 1 August 2023) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an unannounced focussed inspection of this service on 6 June 2023. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment. safeguarding, consent and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained inadequate. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Saffron House on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the assessment and mitigation of people's risks and medicines, safeguarding people and good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.