Background to this inspection
Updated
3 October 2023
Inspection team
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.
Inspection team
The inspection was carried out by 1 inspector and 1 Expert by Experience. 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
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
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 not a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that a member of staff would be available to support the inspection.
What we did before the inspection
We used the information the provider sent us in the provider information return. 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 information gathered as part of CQC's monitoring activity that took place on 14 June 2023 to help plan the inspection and inform our judgements. We used all of this information to plan our inspection.
During the inspection
Inspection activity started on 4 July 2023 and ended on 13 July 2023. We visited the location’s office on 4 and 6 July 2023 and completed phone calls to people and relatives on 5 July 2023.
We spoke with 10 relatives of people who used the service. We spoke with 7 staff including the manager, assistant care manager, care coordinator, 3 care assistants and chief operating officer. We reviewed the relevant parts of 12 people's care plans and multiple medicines records. We looked at other records including feedback gathered by the provider, policies, audits, training records and 3 staff recruitment files.
Updated
3 October 2023
About the service
ICare (GB) Limited - Sunnyfield Court is an extra care service. The service provides personal care and support to older people, some who may be living with dementia, mental health and physical and sensory disabilities. Some people had learning disabilities and / or autism. At the time of our inspection there were 30 people using the service.
Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.
People’s experience of using this service and what we found
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.
The service was not registered as a specialist learning disability service however, we assessed the care provision under Right Support, Right Care Right Culture as it did provide personal care to some people with learning disabilities and / or autism.
The service was not able to demonstrate how they were meeting underpinning principles of “Right Support, Right Care, Right Culture".
Right Care: People did not always receive safe care as their needs and associated risks were not always assessed. Actions to reduce risks were not always identified and taken. Medicines were not always managed safely and in line with good practice. Systems to safeguard people were not always operated effectively. There were enough staff and recruitment checks had been completed.
Right Support: People were not supported to have maximum choice and control of their lives and the service did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People’s involvement in their care and treatment was limited as care plans and risk assessments were out of date and not always kept under review.
Right Culture: Systems to ensure the quality and safety of services and reduce risks were not operated effectively. Incidents, accidents and feedback had not led to the identification of lessons learned and improvements. Complaints management systems were not effective. Policies and procedures were not always followed.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
We registered this service on 23 December 2021 and this was the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have found breaches in relation to seeking people’s consent, the provision of safe care and treatment and how the provider manages the service and ensures its quality and safety at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is inadequate and the service is therefore in special measures. This means we will keep the service under review and will re-inspect within six months of the date we published this report to check for significant improvements.
If the registered provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question, we will take action in line with our enforcement procedures. This usually means that if we have not already done so, we will start processes that will prevent the provider from continuing to operate the service.
For adult social care services, the maximum time for being in special measures will usually be 12 months. If the service has shown improvements when we inspect it, and it is no longer rated inadequate for any of the five key questions, it will no longer be in special measures.