Washwood Healthcare Service

People’s experience of using this service:

Since the last inspection in July 2019, some improvements had been made to address the areas we had identified as requiring action, however this inspection found that further improvements were still required.

We found that all required improvements in the infection control processes within the home had not been fully addressed and therefore continued to pose a risk to people’s safety.

The processes in place to monitor, audit and assess the quality of the service being delivered were not fully effective. Although some improvements had been made, we found provider audits had not identified some of the concerns we raised at this inspection.

People were supported to receive their medicines as required to support their wellbeing.

Staff understood of the importance of gaining consent from people before providing support. However, staff spoken with had limited knowledge of the MCA and how this impacted on the care provided to individual people.

Staff received training that was appropriate to them in their role and supported them in providing care in the way people wanted.

We found although some environmental improvements to the design and decoration of the home to support people’s individual needs had been addressed further improvement was still required.

Staff liaised with other health care professionals to meet people’s health needs and support their wellbeing and provided care in the way that people preferred, and people felt able to raise any concerns they may have with staff.

People gave positive feedback about the choice of food provided which they told us they enjoyed.

We people were offered regular drinks throughout the day to support their wellbeing.

People and staff we spoke with told us there had been some improvements in the activities provided. The provider told us activities were under review to ensure they met people’s needs.

Staff felt supported and said they could talk to manager for advice and support and felt confident any concerns would be acted on promptly.

People, relatives and staff spoke of improvement within the service since the last inspection. The provider had a home improvement plan in place to develop the service further and they worked in partnership and collaboration with other key organisations to support care provision.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was inadequate (published September 2019) and there were multiple breaches of regulation.

This service has been in Special Measures since September 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Enforcement

Since the last inspection in July 2019 there has been a condition placed on the providers registration. This condition instructed the provider to send us regular updates on checks that had been carried out at the service to ensure the quality and safety of the service. The provider has submitted updates as per the condition in place.

This inspection found that whilst some limited improvements had been made the provider remains in breach of regulation 12 (safe care and treatment) and regulation 17 (good governance). The provider was also found to be in breach of regulation 18 (Notification of other incidents). The condition will remain on the providers registration.

Please see the action we have told the provider to take at the end of this report.

Follow up:

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Grassmere Residential Care Home is a care home registered to provide personal care for up to 26 people living in a converted building over two floors. Many people were living with varying stages of dementia; there were also people living with a range of complex health care needs that included those diagnosed with a mental illness, diabetes and neurological conditions. At the time of our inspection, there were 25 people living at the home.

People’s experience of using this service and what we found

Since the previous inspection in June 2017, there had been changes in ownership and management of the home. During this inspection we found that the registered provider was in breach of regulations in relation to safe care, person centred care, maintenance of premises and governance. We saw that there were some aspects of the building that were not well maintained and in need of refurbishment to make it a more pleasant place for people to live.

People, relatives and staff gave us feedback about the changes that had been introduced by the provider that had not enhanced people’s experiences of care. The provider acknowledged that many improvements were needed to improve the quality of the environment and the care offered.

Work was needed to make sure risk assessments were up to date and reflected people’s current needs. Staff did not always know how to keep people safe because there was a lack of detailed guidance available to them. Staff did recognise signs of abuse and understood how to report concerns.

Care plans needed updating to reflect individual choices and preferences; they also needed to be reviewed as people’s needs changed to ensure they received responsive care. People told us they wanted more activities to keep them active and that were in line with their interests.

Improvements were needed to make sure all information was given to people in a format they could understand so they could become more involved in their care. Staff that had worked at the home for a long time knew how people preferred to communicate because they were familiar with their needs.

Staff treated people with care and respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However the policies and systems in the service did not support this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 16 August 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care, person centred care, maintenance of the premises and quality assurance processes at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

The overall rating for this service is ‘Inadequate’ and the service is therefore 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 rating, 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.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.