What life is like for people using this service:

The service was newly registered in October 2017, and began admitting people in February 2018 following refurbishment works. The service had a registered manager in post and a deputy manager.

Staffing levels did not consider the needs of people living with dementia, mental health or with complex care needs. People had to wait for key areas of support such as meals, drinks and personal care, along with not receiving appropriate support with their behaviour which challenged others. The manager and deputy worked along side staff and had no time to ensure that the overall care people received was safe. This led to a lack of monitoring of people’s hydration, nutrition and pressure area care monitoring. On the first day of our inspection we discussed our findings with the provider. They immediately took action and increased staffing levels accordingly.

People told us they did not always feel safe, and the registered manager had not reviewed people’s needs when incidents occurred. Staff were aware of how to keep people safe from harm and when to report concerns. Staff were not able to review incidents openly to learn lessons when things went wrong. The provider undertook a guarantee to review their safeguarding practises and provide staff with additional training.

Staff were not trained to provide care effectively. The registered manager had not ensured staff received training in key areas such as pressure care, continence and dementia care. This impacted on staff awareness and ability to proactively and positively support people. The provider gave us assurances they would review their training program. On the second day we saw training had been booked and delivered in key areas such as pressure care and medicines management.

People’s consent had not been obtained in line with the legal requirements necessary, particularly where people lacked the capacity to provide this consent. The process to assess a person’s capacity was not followed and documented as required. The registered manager and deputy manager told us they were in the process of reviewing this.

People did not consistently receive care based upon their needs and preferences. Staff were aware of people’s preferences and choices, however staffing levels did not allow this to be delivered. The additional pressures placed on staff meant they were not able to establish meaningful relationships with people. People told us they felt well cared for by staff who treated them with respect and dignity. People were not always provided with range of activities or social inclusion and told us they felt bored at times. On the second day of the inspection we saw increased staffing had a positive effect with staff having more time to spend with people.

We were not confident the registered manager and provider understood their role in engaging with the whole staff team to listen and support them to improve. The registered manager completed some audits and checks of the safety and care in the service. However, these did not identify the issues raised at this inspection, for example with staffing levels, training and personalised care. The provider did not monitor the quality of care in the service. Records we looked at did not always reflect the support provided to people, or rationale for decisions made. We discussed this with the provider who agreed they needed to develop systems to monitor the service closely.

More information is in Detailed Findings below

Rating at this inspection: Inadequate

The overall rating for this service is 'Inadequate' and the service has been placed in 'special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements wit