Privately run care homes which fail to provide an acceptable level of care will be held to account, Northern Ireland’s Chief Social Worker has made clear.
Sean Holland was commenting after two independent assessments confirmed important improvements had been implemented at Dunmurry Manor since significant concerns were raised.
Both reports relating to Dunmurry Manor were commissioned by the Department of Health (DoH) - one assessed the home’s current standards of care; while the other focused on actions taken by Health and Social Care (HSC) Trusts and the Regulation and Quality Improvement Authority (RQIA) in response to problems.
Significant concerns had been raised on critical issues at the home including the safeguarding of residents, care and treatment, management of medicines, the quality of personal care provided by the home and staffing difficulties.
These problems are also due to be addressed in a forthcoming report by the Commissioner for Older People for Northern Ireland (COPNI).
The Department is today publishing findings from both independent assessments to give assurance to current residents and their families that concerns have been taken seriously and to help provide a full context for COPNI’s work.
CPEA - a social care, health and management consultancy – conducted a “rapid safeguarding review” to scrutinise concerns raised about care at Dunmurry Manor and the HSC’s response to them.
As part of this process, the DoH is today publishing an interim CPEA report to provide independent professional evaluation and assurance on Dunmurry Manor’s present day standards of care and support.
CPEA’s report, produced following a two-day review of the home, states: “During the visits Dunmurry was assessed as being a safe place for people to live quality lives.”
This is in keeping with RQIA’s most recent findings from its inspections of the home.
The Care Inspectorate - the official scrutiny body for Scotland’s health and social care system – examined the appropriateness of the RQIA’s role in regulating Dunmurry Manor, and RQIA’s response when issues arose.
Its report states: “This review found that RQIA had promoted good practice, encouraged improvements and took action to protect people using the service when poor practice was identified.”
Sean Holland, the Department’s Chief Social Worker, today said:
“I recognise the concerns of residents and their families when care falls short; it is vital that effective action is taken to deliver improvements and put things right.
“The primary responsibility for providing safe and satisfactory care in such homes rests with the operators. However, when problems are identified, residents and their families need to know that Trusts and the RQIA will intervene.
“Care providers will continue to be held to account, for instance through enforcement action as happened in this case. They will also be supported in addressing problems and making necessary improvements.
“There are always lessons to be learned in health and social care, we are always working to improve our systems; and I trust the COPNI report will help us in that regard with Dunmurry Manor.
“It is also important to assure residents, their families and the general public on the improvements in the home and the important work done by Trusts and the RQIA to help bring this about.”
Notes to editors:
1. The two reports published today are available here.
2. Key quotes from both reports are detailed below.
CPEA preliminary report
The CPEA report on current standards at Dunmurry Manor notes that “RQIA reports since 2014 show the home went through difficult times resulting in the many inspection visits from the care inspectors, pharmacy and estates. There were additionally weekly visits from professionals from commissioning Health Trusts who carried out audits.”
It states that there had been a high turnover of managers and that consequently “ the home experienced difficulties in maintaining standards and compliance”.
A new manager was appointed and started work in May 2017. “It is well evidenced in the RQIA inspection reports and from comments made during the visit by staff, visitors and residents that the home has been consistently improving since the new manager has been in post, “ CPEA’s examination states.
Reporting on its visits to Dunmurry Manor, CPEA states: “Observations throughout the visits showed staff related to residents in an appropriate way that demonstrated their values in respecting and caring about the individual residents. This approach was confirmed by the visitors and residents with expressions such as: I trust the staff and I feel safe here.”
It also states: “During the visits Dunmurry Manor was assessed as being a safe place for people to live quality lives.”
CPEA also comments: “Undoubtedly the organisation will have reviewed the situation they found themselves in and be looking at what they could have done differently to ensure they were fully compliant from initial inspection visit concerns.”
CPEA further noted: “The management of records, both computerised and paper, may need to be kept under review to ensure the practice of care is fully reflected in a personalised way.”
Care Inspectorate report
The report by the Care Inspectorate –Scotland’s social care regulator – examined RQIA’s work in regulating Dunmurry Manor and responding to issues of concern found by inspectors. Key points include:
“Enforcement action was taken against the provider of Dunmurry Manor care home in October 2016 when three ‘failure to comply notices’ were served. It is the reviewer’s view that all scrutiny activity taken prior to these notices being served was in line with the ways in which a regulator of care services should support improvement in a new service that was facing difficulty in recruiting and retaining a registered manager. This review found that RQIA had promoted good practice, encouraged improvements and took action to protect people using the service when poor practice was identified.”
“The regulatory actions taken by RQIA in respect of pre-registration, registration; and inspection activity aligned with their policies in procedures that were in place at the time covered by this review.”
“Actions taken by RQIA when non-compliance with standards and regulations was found by inspectors were appropriate and in line with the policies and procedures in place at the time covered by this review.”
“The documentation examined by this review in respect of enforcement decision-making and activity demonstrates that RQIA ensured that the responsibilities for the implementation and application of the enforcement policy and procedures were being dealt with at the appropriate level and in accordance with policies, procedures and timescales in place at that time.”
“Dunmurry Manor had a high number of inspections carried out since it was first registered. High levels of scrutiny can burden services and may not necessarily support them to improve when they are failing. There is a balance to strike to ensure that regulators are responsive and robust in their role of protecting people using services, whilst being proportionate and supporting improvement.”
“In conclusion, and notwithstanding the recommendations made herein; this review found that RQIA regulated Dunmurry Manor care home in accordance with the policies and procedures in place at the time. Significant consideration has been given by RQIA into ways in which they can improve their systems and process and work is in progress in a number of the areas covered in the recommendations made in this report. Thanks are extended to RQIA staff for the time and cooperation given to this review.”
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