The inspection took place on 8 and 9 December 2015 and was unannounced. We previously inspected the service on 11and 13 May 2015 and found that the service’s medicines procedures and recording practice needed improvement in order to maintain people’s safety consistently.
The service provides accommodation and personal care for up to 60 older people. This service does not provide nursing care. At the time of our inspection there were 55 people using the service. The service has a registered manager supported by a deputy 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 2008 and associated Regulations about how the service is run.
People’s feedback regarding The Croft was critical. They told us that too many agency staff work at the home and this had an impact on the quality of care. Several members of staff had told us they had provided feedback to management about the lack of support they receive in carrying out their duties, however they felt nothing had changed.
Staff had received training in topics such as fire safety, manual handling, and mental capacity. However, staff supervision were not being held on a regular basis.
People’s privacy was not maintained as there were large white notice boards displayed throughout the home with personal information of people on display.
People were not protected by The Deprivation of Liberty Safeguards and had restrictions placed upon them without staff having the authorisation to do so.
Complaints were not listened to or acted on and this led to a failure to use this information to improve the quality of care received. Staff were kind and caring in their approach to the people who lived in the home.
The risk assessment process to identify risks to people and how they were to be eliminated or managed were not always being carried out or recorded. This meant people were not always being protected from identifiable risks to their health and safety.
Policies and procedures in relation to safeguarding of adults accurately reflected local procedures and included relevant contact information. All of the staff we spoke with were able to explain the procedures in relation to the safeguarding of adults.
People’s care plans did not always reflect the care that had been carried out. Accidents and incidents were not recorded accurately and had not been investigated appropriately.
We found where people sustained unexplained bruises, no action was taken to investigate or escalate them to the appropriate agencies. This placed people at risk of unsafe care and inappropriate care.
The décor of the home was in need of updating, some of the ceilings had large damp patches where water had leaked from one of the rooms.
We observed staff to be rushed and task focused and had little time to interact with people. We found that there were not sufficient numbers of staff to meet the needs of the people in the home.
We found that there were 11 staff in the building for 55 residents. Most of the residents were living with dementia and had a high level of need. Additional staff were a deputy and a shift leader however they did not work directly on the units and were in the office on both days of our visit.
The home has largely agency staff who work in the home due to difficulty in recruiting permanent staff. However the home tries to ensure the same staff are requested from the agency.
Medicines were not administered safely and in a timely manner. We saw the morning medicine round still being carried out at 11.a.m this meant that the people who required a lunch time dose of medicine would be at risk of receiving it too close to the morning dose. The medicine cupboard was observed to be left open and unattended on the second day of our visit. We were also aware that controlled medicine had not been correctly booked in in the appropriate book. Some stock of medicine did not reflect what was left in the medicine box. On the first day of our visit we were aware that two medicine errors had occurred.
Staff had received training in the administration of medicine. Quality assurance systems did not effectively assess or monitor the quality and safety of services provided. Activities were not planned in accordance to the people who were able to participate.
The provider was not meeting the requirements of the law. You can see what action we told the provider to take at the back of the full version of the report.