St Anne's Community Services - The Crescent

Updated 3 September 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector, one member of the CQC medicines team and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St Anne’s Community Services – The Crescent is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Anne’s Community Services – The Crescent is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff including the registered manager and support workers. We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision.

After the inspection

We reviewed a variety of records relating to the management of the service, including policies and procedures. We looked at training data and quality assurance records. We continued to seek clarification from the provider to validate evidence found.

Updated 3 September 2022

About the service

St Anne’s Community Services – The Crescent is a residential care home providing accommodation and personal care to up to 5 people, in one adapted building. The service provides support to people with learning disabilities and people who may be living with autism spectrum disorder. At the time of our inspection there were 5 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support: Model of Care and setting that maximises people’s choice, control and independence

Support was provided to ensure people received their medication as prescribed however records in place did not always reflect best practice. We made a recommendation about this. The service gave people care and support in a well-furnished environment that met their sensory and physical needs. People had choice about their living environment and were able to personalise their rooms. Improvement is needed to ensure the cleanliness of the service meets a good standard; we made a recommendation about this and the registered manager took action to review their practice and improve. Staff supported people to take part in activities and pursue their interests however staff told us an increase in staffing would provide people with greater opportunities to access the community. People were supported by staff who knew them well and staff supported people to make decisions following best practice in decision-making. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights

The service had enough staff to provide safe care however refresher training was needed to ensure staff practices were in line with best practice. People could communicate with staff and staff understood their individual communication needs however more work is needed to ensure all information within the service is accessible. We fed this back to the registered manager who planned improvements. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff promoted equality and diversity in their support for people. Relatives we spoke to were happy with the care provided; One relative said, “They just do a good job and [person] is happy.”

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

People’s care, treatment and support plans did not always reflect their range of needs and support required. However, staff turnover was low, which supported people to receive consistent care from staff who knew them well. The service did not have clear guidance on what people’s goals and aspirations were so these were not monitored however, staff worked with people to meet their aspirations. The service enabled people and those important to them to work with staff to develop the service. Staff placed people’s wishes, needs and rights at the heart of everything they did. One staff member said, “We want to ensure the people have the best quality of life.”

We received positive feedback from people and their family members about the service. One relative when speaking about the staff, told us, “They’re all good, and lovely to talk to.” Another relative said, “It’s just good, and I have no concerns at all because [person] is well cared for.”

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 January 2020) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an announced comprehensive inspection of this service on 3 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safety and governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains as requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Anne’s Community Services – The Crescent on our website at www.cqc.org.uk.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safety and governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.