Care Home for Special Needs

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was a risk that people could be harmed. Environmental risks were not always assessed and we found incidents were not reviewed for any trends to prevent similar incidents occurring. The registered manager explained that due to the small number of people at the home, there was not enough data to analyse trends.

The provider did not follow their own policy for staff recruitment.

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

People were involved in decisions about their care. They had access to information regarding care planning and were given choices about how to stay healthy and live as independently as possible.

We found staff were not making daily records about interactions with people.

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment, we rated this key question as requires improvement. At this assessment, the rating remains the same.

This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. For example, staff did not complete full application forms and information regarding conduct in previous roles was not available. A lack of audits and quality checks meant issues identified at this assessment had not been identified by the provider.

The registered manager did not maintain effective oversight of Deprivation of Liberty Safeguards (DoLS) by monitoring applications to the authorising body. Environmental safety risks were not always assessed, mitigated or monitored.

Staff were not recruited according to the provider’s own policies., Accurate and complete records of the care and treatment provided to service users were not always in place.

At our last inspection of this service, we identified similar shortfalls in good governance. The service was in continued breach of the legal regulation in relation to the governance of the service.

This has resulted in a repeated breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.