Teamcare Limited t/a Highcliffe Residential Home

At the last rated inspection in 2017 the home was rated good. At this inspection we found standards had declined and the home was now in breach of legal regulations for; consent, safe care and treatment, safeguarding, premises and equipment and governance.

Incidents were not adequately reviewed, and appropriate actions were not taken to help prevent reoccurrence. Information was not always gathered about people as they moved into the service, to help support safe transitions. Safeguarding systems were not effective, and the home did not work in line with the Mental Capacity Act 2005 (MCA) when people were deprived of their liberty. Staff did not have access to adequate information about risks to people’s health or wellbeing, including for those people who communicated a need, emotion or distress. There were several gaps in staff training. Some areas of the home environment were unsafe, and we found concerns relating to security, fire safety and infection prevention and control. Medicines were not managed safely.

Care plans lacked key information about people and records were not completed consistently to show people received support in line with their assessed needs. Staff were not involved in daily handover meetings and gave some negative feedback about communication amongst the team. Assessment tools were not used consistently to monitor people for signs of deterioration. Consent was not sought in line with MCA principles, and staff did not have access to information about people’s capacity.

We could not be assured people’s care was person-centred because information in care plans did not fully reflect their individual needs and preferences. There was limited evidence to show people and their relatives were involved in making decisions when people’s needs changed. People who had a terminal diagnosis or were at end of life, did not always have an associated care plan to ensure their wishes were recorded and shared with the team.

Leaders at the home were not aware of the key issues and risks at the home. Staff did not always feel they could speak up and opportunities for them to do so were limited. Governance systems were inadequate and oversight was poor. The provider and registered manager had not always used information, recommendations from external agencies or feedback from staff to drive improvement at the home.

However, the home worked closely with healthcare partners and staff encouraged people to improve their mobility. Staff were kind and caring and treated people like individuals. There was a weekly timetable of activities and people were supported to have choice and control over their lives. Staff felt valued and well supported and spoke positively about the registered manager and their colleagues. Staff were flexible and people enjoyed good continuity of care. People had access to information about the service and were given the opportunity to feed back about their experiences. The home was adapted to meet the needs of people living there. There was a positive culture which ensured people were treated with compassion, dignity and respect. The registered manager worked in partnership with other services and agencies to seek advice and share learning.

We have taken regulatory action against the registered manager; we have published this information on our website and have asked the provider for an action plan in response to concerns found at this assessment.