Background to this inspection
Updated
27 September 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 [the Act] as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was completed by one inspector.
Service and service type
Caradoc House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. In this instance the registered manager was also the provider. This means they are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality.
During the inspection
We spoke with three people who used the service about their experience of the care provided and we spent time in the communal area observing the support people received. We spoke with six staff members including care staff, deputy manager, cook, registered manager and maintenance manager. We also spoke with the operations manager on the telephone. We looked at three people’s care and support plans, several documents relating to the monitoring of the location and health and safety checks. In addition, we looked at two staff files.
Updated
27 September 2022
About the service
Caradoc House Residential Care Home is a care home providing support with accommodation and personal care for up to 11 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of this inspection 10 people were receiving accommodation and personal care, some of whom were living with dementia.
People’s experience of using this service and what we found
People were not safe. The provider failed to ensure substances hazardous to health were safely stored, firefighting equipment was readily available or that window restrictors were in place on all windows.
The provider did not effectively analyse significant incidents to learn from them and to make changes to improve people’s safety. The provider’s infection prevention and control procedures were not effectively followed.
People were not always treated with dignity or respect. Confidential information was not secured and was accessible to those without authority. People’s personal property was not safely or appropriately stored.
The registered manager did not model a positive example of interaction and engagement with people and did not value people’s personal space. People were not protected from ill-treatment or abuse as the provider did not have robust systems in place to safeguard people.
People’s medicines were not safely stored, and the provider did not have checks in place to ensure people received their medicines as prescribed.
The provider failed to ensure there were enough suitably qualified staff deployed at all times.
The provider failed to notify the CQC of all significant events as required.
The provider did not have effective quality monitoring procedures in place to drive improvements in the care they provided. The management team did not have clearly defined roles and responsibilities.
Staff members knew what to do if they suspected something was wrong. People were complementary about the staff who supported them on a day to day basis who they found to be kind and caring.
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible or in their best interests; the application of policies and systems in the service supported best practice.
The provider followed safe recruitment practices.
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 requires improvement (published 10 September 2021).
At that inspection improvements were needed in order to keep people safe and on how the location was managed.
Why we inspected
The inspection was prompted by concerns about the management of the location. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only.
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 the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence the provider needs to make improvements. Please see the safe, caring and well-led sections of this report.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to 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 Caradoc House Residential Care Home 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 monitor the service and will take further action if needed.
We have identified breaches in relation to keeping people safe, dignity and overall governance.
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
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.