About the service: Florence Shipley Residential and Community Care Centre is a residential care home that was registered to provide accommodation for up to 32 people. At the time of our inspection there were 22 people living there. The care home has eight intermediate care beds in the 'Bailey' unit. The aim is to facilitate discharge from acute settings, and to support people to return home, prevent hospital admission, or long-term care. It also has sixteen spaces for longer term care across two units called 'Woodside' and 'Coppice' which are on different floors. They specialise in providing care to people living with dementia. Each of these units has separate communal facilities. A fourth short stay unit which accommodates a further eight people was not open on the day of the inspection visit.

People’s experience of using this service:

The overall rating for the service is inadequate and the service will be 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 within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

After the last inspection the provider had provided us with an action plan to manage staffing levels more effectively. At this inspection we found ongoing concerns about the numbers of suitably qualified staff available to meet people’s needs during the day and night. Therefore this plan had not been effective.

Risks associated with people’s care and support were not always managed safely. This put people at risk of harm from falling, choking and from other people’s behaviours. These risks were not always identified or reported to the relevant authorities to safeguard people from abuse.

Staff did not have sufficient training to enable them to provide safe and effective care. People did not always receive enough to drink to maintain their health and specialist diets were not always provided correctly. Relationships with healthcare professionals required improvement to ensure staff in the home were following established guidelines to support people. People’s capacity to make decisions was not always clear. This meant people were not always supported to have maximum choice and control of their lives and staff didn’t always support them in the least restrictive way possible.

Staff did not always protect people’s privacy and dignity when supporting them. People were not always included in making choices in a meaningful way. They did not consistently receive personalised care that met their needs. People were not always provided with opportunities for meaningful activity.

The provider

This inspection took place on 12 January 2018 and it was unannounced. It was the provider’s first inspection at this location.

Florence Shipley Residential and Community Care Centre is a large purpose built building which provides a range of facilities including advice, information, day respite, rehabilitation and health support services. They are registered to provide residential care to 32 people within the ‘care home’.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates 8 intermediate care beds in the ‘Bailey’ unit. The aim is to facilitate discharge form acute settings, and to support people to return home or to prevent hospital admission or long term care. It also has 16 spaces for longer term care across two units called ‘Woodside’ and ‘Coppice’ which are on different floors. They specialise in providing care to people living with dementia. Each of these units has separate communal facilities. At the time of our inspection they were providing support to 24 people; 8 in each of the three units described. A fourth short stay unit which is registered to accommodate a further 8 people was not currently open.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were not always enough staff deployed in some units to meet people’s needs safely. This also impacted on the fact that there was not always enough support for people to pursue interests and engage in activities.

Staff received training and support to enable them to fulfil their role effectively and were encouraged to develop their skills. They understood their responsibilities to identify and report abuse. They felt supported by the registered manager and received regular supervisions.

Staff had caring relationships with the people they supported. They understood how people communicated and supported them to make choices about their care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. They knew people well and provided care that met their preferences. People’s privacy and dignity were maintained at all times. They were supported to have important family relationships.

People were supported to maintain good health and had regular access to healthcare professionals. Their care plans were regularly reviewed to correspond with changing support needs and they were personalised and accessible. Risk was assessed, actions were put in place to reduce it and their effectiveness was reviewed. Medicines were administered as prescribed and they were stored safely.

Quality monitoring systems were effective in highlighting errors and implementing actions to ensure that they were addressed. This included infection control measures and processes which demonstrated that lessons were learnt when things went wrong. There was a procedure in place for people to complain; and although no complaints had been received the registered manager resolved all concerns in line with it.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.