About the service Headingley Court is a care home providing personal and nursing care for younger adults with a physical disability. It can accommodate up to 25 people. There were 23 people using the service at the time of the inspection.
People’s experience of using this service and what we found
We found systems and processes used to ensure the service was running safely were not effective. They had not identified required improvements, therefore they were not effective to ensure the service was running safely. We observed lack of leadership, direction and oversight. Staff told us they did not feel listened to.
Risks associated with people’s care were not always identified or managed in a way that kept people safe. Incidents and accidents were not effectively reviewed to ensure lessons were learnt to drive improvements. We identified some shortfalls in the way people’s medicines were managed. We were not fully assured people were protected by the risk and spread of infection, although this was addressed by the registered manager.
Staff were not always deployed effectively to ensure people’s needs were met. We observed people who were meant to be supported on a one to one basis with no support. We observed staff were not present in communal areas, we observed people waiting for assistance and staff not having time to talk to people. Staff had not consistently received specific training to meet people’s needs. Staff did not receive effective competency checks on their performance and abilities to ensure they carried out their roles and responsibilities safely. There were systems in place to safeguard people from abuse. However, we referred a safeguarding concern to the Local Authority, which we identified at inspection.
Staff told us they did not always get opportunity to spend time with people, they were rushed and often short staffed. Therefore, staff did not always support people appropriately. Care and support we observed was task orientated and not person-centred. Staff did not always show concern for people’s well-being. For example, we observed people left with no interaction or stimulation for long periods of time.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. There was lack of evidence to show that people were involved in decisions about their care, support and treatment. Relatives we spoke with told us there was lack of communication during the pandemic.
We identified a closed culture, people did not have their human rights upheld, protected characteristics were not recognised or respected and equality was not promoted.
We saw people were referred to health care professionals and advice obtained. However, from documentation it was not always clear if the advice was followed. Therefore, it was not clear if people’s needs were being met. Care plans did not always detail people’s current needs, were difficult to follow, were contradictory, inconsistent and not person centred.
The service was purpose built and the adaptation and design could meet people’s needs. Complaints were recorded in line with the provider’s policy.
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 4 February 2020)
Why we inspected
The inspection was prompted due to concerns received from the local authority commissioners and safeguarding referrals. These were regarding, risks not being managed and allegations of abuse. We completed a site visit to look at the safe, effective and well led key questions. Following the concerns, we identified at this visit, we included the key questions of caring and responsive, therefore we have looked at all key questions.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see all sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ’Headingley Court’ on our website at www.cqc.org.uk
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment, consent to care and treatment, person centred care, staffing and governancet 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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special Measures
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.