The Bungalow

Updated 13 July 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: This inspection was undertaken by one adult social care inspector.

Service and service type: The Bungalow is a small 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: This inspection was announced the day before the inspection. This was because the care home is small and we needed to be sure that staff and people living there would be in when we visited.

What we did: Before the inspection we reviewed any information we had about the service since the last inspection. This included looking at the provider’s provider information return which gives us key information about the service, what the service does well and information on the improvements the provider plans to make. Provider are required to submit this information at least once a year. We also contacted the local authority to gain their feedback on the service and then used all this information to plan our inspection.

We talked with one person who used the service and a relative. We spoke with the registered manager, the house manager and a support worker.

We reviewed a range of records. This included two people's care records, staff records and other records relating to the management of the service.

Updated 13 July 2019

About the service: The Bungalow is a small residential property that accommodates three people living with learning difficulties who required help with personal care.

People’s experience of using this service:

In June 2017, CQC published guidance called ‘Registering the Right Support’. This along with other associated good practice guidance sets out the values and standards of support expected for services supporting people with a learning disability and or autism.

The principles of ‘Registering the Right Support is on ensuring that people who use services can live as full a life as possible and achieve the best possible outcomes. They reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The Bungalow was built and developed prior to this guidance being published. This meant that there were some aspects of the service that did not comply with this guidance.

The home was located in a campus style setting with other autism together services which did not meet the principles of Registering the Right Support. There were signs on the campus site which identified to anyone visiting The Bungalow that the home was part of a range of services for people living with learning difficulties. These aspects of service design did not comply with the principles of Registering the Right Support.

People living in the home however were supported to be independent as much as possible, were encouraged to make informed and positive choices and led meaningful lives in the community. They had access to community services for social and recreational pursuits and health care services in support of their well-being. This was good practice and reflected the fundamental principles of Registering the Right Support.

There were systems in place to check the environment, medicines, care planning and service delivery. Some of these systems were not always effective. For instance, they failed to identify that staff training was not always completed or that best interest decision making at the service required improvement.

The number of medicines administered at the home was minimal. Records showed medicines were managed correctly. Records indicated however that some staff had not completed training in medication administration. This increased the risk of errors and poor practice. Training information provided by the manager also indicated that some staff members had not completed training in safeguarding, mental capacity act, first aid and MAPA (management of challenging behaviours). This aspect of service delivery required improvement.

Where people found it difficult to make specific decisions about their care, their capacity to consent was assessed in line with the Mental Capacity Act 2005. But where decisions were made on people’s behalf, there was little evidence of their involvement or the involvement of relevant others (i.e., family members, social worker) in this process. This required improvement.

People’s needs and risks were assessed and staff had clear guidance on how to provide safe and appropriate person centred care. It was clear staff knew people well. People who lived at the home looked happy, relaxed and comfortable with staff and feedback on the service and the staff team was positive.

People received enough to eat and drink and they were involved in menu planning and meal preparation with staff support. People’s needs were met by a range of health and social care professionals and staff supported people to attend external appointments in support of their mental and physical well-being.

Regular meetings took place with people living in the home and staff to ensure that their views and opinions with regards to the service were sought.

Staffing levels were sufficient to meet people’s needs and staff employed at the service had been recruited safely. Staff told us they felt supported by the manager and records showed they received regular supervision in their job role.

The culture of the service was open and transparent. It was clear that there were aspects of the service that were well-led. People liked living in the home, the staff team were positive and committed to their job role and people’s care was well managed.

Rating at last inspection and why we inspected: This was a planned inspection based on the previous rating. The overall rating at the last inspection was good (published 15 December 2016). At this inspection, the overall rating has changed to ‘Requires Improvement’.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.