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Date of assessment 02 April 2025 to 21 May 2025. We assessed the service because it had not previously been inspected, and we had received concerns about the leadership of the service in relation to staff working from overseas on a sponsorship license. We assessed 33 quality statements in the safe, effective, caring, responsive and well-led domains. Lessons were not always learnt to continually identify and embed good practice. Some people’s risk were not being managed safely and some people had not been safeguarded. Some care plans, risk assessments and relating documents contained conflicting information or in some cases did not have the information available. Care plans did not always have evidence-based guidance for staff to follow and did not always include person-centred information. The provider did not make sure that medicines and treatments were safe and processes to assess whether people had capacity to make specific decisions and to make best interest decisions on their behalf were not always in line with legislation and national guidelines. The provider did not always listen to and understand people’s needs, views and wishes and did not always promote people’s independence. Systems and processes to ensure people received safe care and treatment were not always effective. Staff provided mixed feedback about their well-being and the support they received from the provider. Overall, partners working with the service provided positive feedback about their experiences, however raised concerns about staff well-being due to long travel distances between home and work. However, the provider assessed and managed the risk of infection and supported people to manage their health and well-being to live healthier lives. Staff told us they had enough time to provide support to people and were able to demonstrate how they adapted their communication needs for different people. Overall, staff were positive about their experiences from an equality, diversity and inclusion perspective. Staff knew how to report incidents to the registered manager. We identified 6 breaches of the legal regulation in relation to person-centred care, need for consent, safe care and treatment, safeguarding, staffing and good governance. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. We have also asked the provider for an action plan in response to some of the concerns found at this inspection. This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a time frame within which providers must improve the quality of the care they provide.
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