One of the reports from CQC in November updated an earlier inspection reports with a record of enforcement action taken, as follows:
Virtue Care Ltd, 42 Alexandra Road – a condition was placed on the provider’s registration
The registered person must not accept any new packages of care providing the regulated activity of ‘Personal care’ from the location (42 Alexandra Road, Suite 3, 42 Alexandra Road, Farnborough, GU14 6DA) without the prior written agreement of the Care Quality Commission. This includes on a permanent or respite care basis.
A number were targeted inspections, conducted to see whether progress had been made towards improving things, or to investigate specific concerns, following previous inspections that rated services inspected.
We undertook this targeted inspection to check on a specific concern we had about the management of medicines.
This was a targeted inspection that considered the safe administration and recording of medicines. Based on our inspection of medicines management we found people did not always receive their medicines as they were prescribed. People did not always receive their medicines in line with safe practice guidance. People did not always receive their time specific medicines at the correct time. People did not always have accurate guidance in their medicines records to support staff to administer their medicines safely.
We undertook this targeted inspection to check on a specific concern we had about the culture in the service.
The provider could not demonstrate how the service met the principles of right support, right care, right culture. This meant we could not be assured that people were always empowered to make choices and be involved in their care and support.
However, some improvements had been made since last inspection and some people were now having more access to community-based opportunities. There were also revised line management structures, which the provider told us would improve the oversight of the care that people received. These aspects of improvement were still under development and had not become fully embedded in people’s experiences.
People were not always supported to have maximum choice and control of their lives and staff did not always support people in the least restrictive way possible and in their best interests. Partner agencies and the CQC have continued to receive concerns around aspects of restrictive practice.
Although the provider was taking steps to improve the governance and oversight of the service, these improvements had not yet become embedded and the CQC and partner agencies and continued to receive concerns relating to the culture in the service.
It will be interesting to see how this develops, and its in no way surprising given what CQC witnesses when they last inspected:
There had been concerns raised about potential verbal abuse and threatening behaviour from staff. At the time of inspection, the provider was in the process of gathering further information relating to these concerns. The provider had taken steps to mitigate the risk of staff currently under investigation working alone with people in the service and were working with the safeguarding authority.
We undertook this targeted inspection to check whether the Warning Notices we previously served in relation to Regulations 9, 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.
This was a targeted inspection that considered medicines, risk management, infection control, staff training and recruitment, assessment of care needs and management oversight of the service.
Staff did not support people with their medicines in a way that promoted their independence and achieved the best possible health outcome. People could not be sure their prescribed medicines were always managed in a safe way. Staff had not received medicines training and had not been competency checked.
Individual risks were not always assessed and managed to keep people safe. Care plans and risk assessments were inconsistent and did not always detail the relevant information staff would need to meet people’s assessed care and health needs. People could not be assured new staff were adequately checked to ensure they were suitable to work with people to keep them safe. We found no evidence that people had been harmed however, systems were either not robust enough to demonstrate staff recruitment was effectively managed.
Within Wurel House supported living service, people and those important to them, were involved in planning their care. Staff were able to communicate well with the person living at Wurel house supported living service, despite staff not receiving Makaton training to help them communicate. The systems in place to audit the quality of the service were not robust or sufficient to alert the provider of the concerns and issues within the service. Audits had not picked up areas which were identified during the inspection. The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Relatives expressed frustration and concerns in relation to the frequency, length and duration of community care visits. However, most relatives gave us positive feedback about their loved one’s care and support from the care staff. They told us, “The carers have been wonderful, they are really caring and they do a good job”; “They are very good”; “They are very friendly” and “The girls are very helpful.”