2 November 2021
During an inspection looking at part of the service
148 Hornsey Lane provides accommodation and personal care to people with long-term mental health needs. The service accommodates 12 people across three floors. At the time of our inspection there were 11 people using the service.
People’s experience of using this service and what we found
During this inspection we found that the management team needed to improve the oversight of the service provision. The provider needed to ensure that all aspects of the service were regularly and effectively monitored and that the service was provided in line with the current government guidelines and legislation.
We found improvements had been made in relation to the infection prevention and control, risk assessment, management of medicines and staffing. There remained some areas of improvement still to be achieved in seeking feedback from people and relatives.
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; the policies and systems in the service supported this practice.
People and relatives said people usually felt happy and safe at the service. We received concerns about how safe the home was in keeping people safe for visitors bringing in COVID-19 and how much information was shared with relatives. External health and social care professionals said that staffing had been a concern due to staff turnover and that some people’s mental health should be able to be responded to in house rather than seeking community mental health colleague’s advice.
The recruitment procedures for staff employed directly by the provider, and from external staff agencies were now safe as, not least for externally recruited staff, the provider was verifying staff background checks. Staff we spoke with understood their role in safeguarding people from harm from others. There were appropriate accidents and incidents procedures in place.
The registered manager understood their legal responsibility around being open and honest with people when something goes wrong and notifying the CQC about significant events at the service. However, we were concerned that a significant event that had happened a few days prior to our visit was not mentioned to us when we were at the home. This had been raised by a senior manager the following day and CQC had been notified via CQC’s notification system.
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 requires improvement (published 8 January 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
The provider completed an action plan after the last inspection to show what they would do and by when to improve to comply with a warning notice. The warning notice had been issued in relation to infection prevention and control. Our previous inspection also found breaches of regulation 12 in respect of risk assessments, fire safety and medicines. There were also breaches of regulation 17 regarding good governance and regulation 18 in respect of staffing.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations and had complied with the warning notice.
Why we inspected
The inspection was prompted to follow up on compliance with the warning notice that had been issued after our inspection in November 2020. A decision was made for us to inspect and examine this and the previous breaches of regulation.
The inspection was prompted in part due to concerns received about protecting people from COVID-19, information sharing, treating people with dignity and respect, staff turnover and managing people’s mental health issues. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider had made improvements but they also acknowledged that more could be done.
The overall rating for the service has not changed from requires improvement. This is based on the findings at this inspection.
Follow up
We will work alongside the provider and local authority to monitor progress.