Heritage Healthcare-Middlesbrough

⚠ Records were not person-centred. They did not contain the information needed to provide the most appropriate care and support to people. .

⚠ People's privacy and dignity was not always maintained.

⚠ Care records contained conflicting information about whether people had capacity to consent. There were no best interests decision records available. Relatives had signed care plans where no LPA was in place. Staff did not know which people had a DNAR and information was not available in care records.

⚠ Care records did not contain accurate information about people's needs and risks. Medicines were not managed safely, there were gaps in medicine records and medicines were not always given as prescribed. Care plans and risk assessments were not always in place for people who needed them. Accidents and incidents had …

⚠ The service had failed to raised safeguarding alerts which meant people were at risk of harm. Staff lacked understanding of safeguarding and training was not up date. There were gaps in safeguarding records.

⚠ Complaints had not been investigated appropriately. We could see that the service had not dealt with people's complaints when they had been made. There were gaps in complaints records. People told us they did not have confidence in the service to deal with their complaint.

⚠ There were gaps in all records looked at during inspection. Audits failed to identify the level of concerns found during this inspection. The registered provider had failed to monitor the quality of the service appropriately.

⚠ There were insufficient staff to care for the new of people using the service. People were not supported appropriately during their induction period. Staff supervision and appraisals were not up to date. There were gaps in training.