26 February 2020
During an inspection looking at part of the service
La Retraite is a care home and was providing personal care to four people with an acquired brain injury at the time of the inspection. The service can support up to 10 people. La Retraite provides accommodation across two floors, with a lift and stairs providing access to both floors. People’s bedrooms had a medicines cupboard, wet room, toilet and a small kitchenette. On the ground floor, people had shared use of a kitchen-diner and lounge, there was also level access to an enclosed rear garden. The manager’s office was on the ground floor.
People’s experience of using this service and what we found
The provider could not be assured there were always sufficient numbers of suitably trained staff to administer medicines between 8pm and 8am.
A formula was being used to determine the numbers of staff deployed across the service. However, the formula calculated care in hours and did not consider people’s individual care needs and the skills and training staff needed to meet these needs.
The provider had worked with local staffing agencies and had improved the numbers of staff working in the home. Staff told us there had been improvements to staffing levels.
Rating at last inspection
The last rating for this service was Inadequate (published March 2020) when we identified seven breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. Following our last inspection, we served a warning notice on the provider. We required them to be compliant with Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by 1 November 2019. At this inspection we found some improvements had been made, but further improvements were needed.
Why we inspected
We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Enforcement
We have identified a breach in relation to staffing. This was because the provider could not be assured there were sufficient numbers of suitably qualified staff to administer medicines throughout a 24-hour period.
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.