A service that provides care to people in supported living is to remain in special measures following a re-inspection by the Care Quaqlity Commission (CQC).
Optima Care, based in Manston, looks after adults in their own homes who have learning disabilities, physical disabilities and mental health needs.
The service was caring for seven people at the time of the inspection in April.
The last inspection in August 2016 found significant shortfalls and the service was rated Inadequate and placed into special measures.
The August inspection found:
- The provider had failed to inform CQC of notifiable events.
- Suitable means of communication were not provided for people on a consistent basis.
- People’s care plans did not contain ways of maintaining or increasing their independence.
- People and their relatives were not involved in updating their care plans or making decisions around their care.
- People did not receive care that reflected their preferences.
- Staff did not have a clear understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards and had made decisions on people’s behalf without seeking their consent or a less restrictive option.
- Care and support was not provided in a safe way to people.
- People were not receiving their medicines safely and in line with the prescriber’s instructions.
- Complaints were not investigated and necessary and proportionate action had not been taken as a result.
- The provider had failed to assess, monitor and improve the safety of the service.
- The provider had failed to mitigate the risks relating to the health, safety and well-being of people.
- The provider had failed to keep an accurate, complete and contemporaneous record in respect of each person.
- The provider had failed to seek and act on feedback from relevant persons.
- There was a lack of suitably qualified, competent, skilled and experienced staff to meet people’s needs.
Special Measures
The failures meant Optima Care at Manston was placed in Special Measures. Services that are in special measures are kept under review and inspected again within six months.
Re-inspection
The reinspection report, published this month, said improvements have been made by the Optima service at Manston but there were areas that still needed work. It graded the service as Requires Improvements, moving it up from the previous Inadequate rating.
A manager had been employed since the August inspection and staffing levels were improved but there was still too much reliance on agency staff.
The report said: “Incidents had occurred when people were being supported by these temporary staff and people’s behaviours that challenge had escalated.
“The incidents had not been managed effectively by staff. Staff had called the police for support during some incidents rather than try to prevent the behaviour occurring using techniques of positive behaviour support.
“There was guidance in place to assist staff with supporting people with behaviours that challenged.
“One person received support almost entirely from the temporary staff; they had not been consulted about or supported to change their support provider.
“Some people required emergency medicine to be administered if they had an epileptic seizure. Staff had not all been trained in how to administer this medicine and people were regularly being supported by staff working on their own who had not had this training.
“There was a risk people would not get their medicine when they needed it to stop their seizures.”
Inspectors found that complaints had not been recorded but also said when people received consistent support there was a positive, person-centred culture and staff were kind and caring.
They also noted that people were treated with dignity and respect.
Monitoring
The service will continue to be monitored to make sure improvements continue.
The report states: “We identified a number of continued breaches of regulations .The service will therefore remain in special measures.
“We will continue to monitor Manston to check that improvements continue and are sustained.”
Optima at Manston now needs to complete a report showing what action will be taken to make sure:
- People are receiving consistent care and are safe
- People are receiving their emergency medicine.
- Complaints are documented, investigated and responded to.
The provider and registered manager has established and operated systems to assess, monitor and improve the quality and safety of the services provided.