Background to this inspection
Updated
12 March 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 8 February 2022 and was announced. We gave the service 24 hours notice of the inspection.
Updated
12 March 2022
About the service
Queen Elizabeth Foundation Dorincourt is a residential care home without nursing providing accommodation and personal care for up to 45 individuals living with complex physical support and health needs, some of whom also live with a learning disability. There are 14 self-contained flats, and two group homes for five and six people and a larger home for 20 people. At the time of the inspection 35 people lived in the service across the different households.
People’s experience of using this service and what we found
The management team carried out a range of quality and safety audits, but actions were not always addressed in a coordinated way or shared with staff. There was a lack of organised approach to continuous improvement of quality and safety and inconsistent management oversight of the overall service priority actions, although we saw some of the identified actions had already been completed. The provider had already started addressing the governance improvement needs.
We identified some concerns around infection prevention and control (IPC) practice in the service. This included staff changing the personal protective equipment (PPE) between tasks and PPE storage. The registered manager addressed those actions immediately after the inspection.
People were protected from the risk of abuse, neglect and avoidable harm. Staff were aware of how to recognise and report safeguarding concerns. Staff knew how to support people safely and individual risks to people were assessed and addressed. People received safe support with their medicines.
There were enough staff deployed to support people. The provider adhered to safe recruitment practices. Staff felt supported in their day to day work throughout the COVID-19 pandemic. People and their relatives were kept up to date with COVD-19 related changes to the service and told us the service had a person-centred and transparent culture. The management team maintained good working relationships with other healthcare professionals and community-based organisations.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
As this was a focused inspection, we did not look at all aspects of Right Support, Right Care, Right Culture. However, we would expect the service to be able to demonstrate how they were meeting the underpinning principles of the guidance. The service was able to show the model of care and setting maximises people's choice, control and independence, the care is person-centred and promotes people's dignity, privacy and human rights and the ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 14 January 2017).
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the management of risks to people receiving care and support and service governance and quality monitoring. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with governance and quality monitoring in the service, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make some improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for
Queen Elizabeth's Foundation Dorincourt on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.