The Old School House Care Home

The Old School House Care Home is a residential care home providing personal care for up to 36 people, including older people and people living with dementia, mental health conditions and physical disabilities. At the time of our assessment there were 22 people living at the service.

At our last assessment the provider was in breach of 2 legal regulations in relation to premises and equipment and good governance. At this assessment shortfalls remained, which meant the provider had not taken sufficient action to ensure consistent standards of quality and safety across the service. The provider remained in breach of legal regulations related to premises and equipment, and good governance. We also identified a further 2 breaches in relation to safe care and treatment and dignity and respect.

At this assessment, we found concerns relating to people’s safety, the quality of care provided and the effectiveness of governance systems. These concerns were reflected across multiple quality statements and demonstrated a service where systems to ensure safe, effective and high-quality care were not consistently in place or embedded.

We observed poor moving and handling techniques and identified unsafe practices which did not follow best practice guidance. Risks associated with nutrition, hydration and skin integrity were not consistently managed safely. Medicines management systems were not always effective, and audits had not identified some gaps such as missing ‘when required’ (PRN) protocols. Environmental risks were not well managed. We found fire safety checks, equipment checks and legionella monitoring were not consistently completed, and some fire doors were not functioning effectively.

Care was not always delivered in line with people’s assessed needs. We identified inconsistencies between care plans and the care people received, including records which did not accurately reflect care delivery. Some people were not supported in a person-centred way, and there was evidence of poor communication and limited engagement.

Leadership and governance were not always effective. There had been instability in the management of the service, with no registered manager in post at the time of our assessment. Governance systems were in place, however these systems were not consistently embedded in identifying, acting on, and sustaining improvements. Audits had identified concerns, including environmental and safety risks, but action had not always been taken or maintained. There was evidence repeated issues identified at our previous assessment had not been fully addressed, including cleanliness and lack of meaningful activity.

Overall, we found ongoing and widespread concerns relating to safety, care delivery and governance. These issues had a direct impact on people’s experience of care, including their safety, dignity and wellbeing.

The provider was working alongside the local authority team and other professionals as part of a safeguarding process. The provider had implemented an action plan to make improvements within the service. Since our assessment as part of local authority safeguarding process, professionals have told us the service is making improvements to the quality of care.

We have asked the provider for an action plan in response to the concerns identified at this assessment.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.