The Care Quality Commission (CQC) has downgraded the rating of Enabling Others Limited in Coalville, Leicestershire from good to inadequate and placed it into special measures to protect people following an inspection in September and October.
Enabling Others Limited, run by a company of the same name, is a supported living service which supports people under the age of 65 living with mental health conditions or learning disabilities in their own homes.
CQC carried out the inspection following concerns it received about the support being provided to people.
Inspectors found that care had deteriorated and the service was now in breach of six regulations in relation to person-centred care, consent, safe care and treatment, good management, staffing, and fit and proper persons employed.
CQC has rated Enabling Others Limited as inadequate for being safe, effective and well-led, down from good. The ratings for caring and responsive have dropped from good to requires improvement.
CQC has placed the service into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures also provides a structured timeframe so services understand when they need to make improvements by, and what action CQC will take if this doesn’t happen.
CQC has also begun the process of taking regulatory action to address the concerns which Enabling Others Limited has the right to appeal.
Greg Rielly, CQC’s deputy director of adult social care for the East Midlands, said:
“When we inspected Enabling Care Limited, it was clear that the standard of care being provided had deteriorated significantly and people weren’t always kept safe.
“We found that the care staff provided to people wasn’t always responsive to their needs, especially when these changed. Staff weren’t always updating people’s care records accordingly and leaders didn’t always provide staff with consistent guidance on how to meet people’s immediate needs safely.
“Leaders also hadn’t implemented effective processes and systems to identify safety issues or ensure improvements were made to people’s care and their safety. We saw staff move a person in an unsafe way while they were having an epileptic seizure and didn't make use of the recovery position to minimise their risk of choking. However, lessons weren’t learnt to continually identify and embed good practice, putting this person, and others, at further potential risk of harm.
“Our inspectors saw staff put people at risk by not always storing or managing medicines safely, and we found that staff didn’t always give people their medicines as prescribed. For example, one person liked staff to crush their medicines and mix them with water, but prescribed instructions said some medicines should be swallowed whole. This meant staff couldn’t always be assured that these medicines were effective for people.
“We have told leaders where we expect to see rapid, and widespread improvements. We will return to check on their progress and won’t hesitate to use our regulatory powers further if people still aren’t receiving the care they have a right to expect.”
Inspectors found:
- Leaders didn’t always ensure people’s care and treatment were effective, and people’s input wasn’t always included in their care reviews.
- Leaders didn't always ensure staff received adequate training for delegated health care tasks, and staff weren’t always competent to deliver safe care, putting people at risk of harm.
- The service didn’t always support people to maximise their independence, choice or control. Staff didn’t always support people to live healthier lives or, where possible, reduce their future needs for care and support.
- Leaders hadn’t established effective safeguarding systems to ensure people were protected from the potential risk of avoidable harm.
- While leaders worked with external healthcare partners to ensure continuity of care between services, the processes in place didn’t always establish or maintain safe systems of care for people. Leaders had made clinical care decisions without consulting medical professionals to ensure they were appropriate, putting people at risk of harm.
- Staff didn’t have suitable oversight of repairs to people’s homes, which prevented them from ensuring people’s environments were well managed and safe.
However:
- People told inspectors they felt safe and well supported by staff, who helped them relax and engaged positively with them.
- Staff understood people’s needs, such as noticing changes to their moods and behaviours and responded in a timely manner. Staff also supported people to do the things that were important to them and to achieve good outcomes in keeping with their personal preferences.