Our House

Updated 3 November 2023

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.

Inspection team

The inspection was carried out by one inspector, one specialist advisor and one medicines inspector.

Service and service type

Our House 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. Our House 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

Notice of inspection

This inspection was unannounced.

Inspection activity started on 24 July 2023 and ended on 24 August 2023. We visited the location’s service on 24 and 25 July 2023 and on 3 August 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 observed staff interactions with the 5 people who used the service and we spoke with them. We used the Quality-of-Life Tool which is designed to support the corroboration of all sources of evidence gathered during inspection. We spoke with 7 members of staff including care staff, the deputy manager, the registered manager, the provider’s assistant deputy director and the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. These included elements of 5 people's care records and all people's medication records. We requested to see 3 staff files in relation to recruitment, but we were only given 1. We looked at supervision scheduling and the supervision records for 2 staff members. We looked at a variety of records relating to the management of the service, including policies and procedures. We looked at training data, communication and quality assurance records. We received feedback about the service from 3 external professionals who had recent and ongoing involvement with the service. We also received feedback from 5 relatives of the people who lived at the care home by phone or email.

Updated 3 November 2023

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.

About the service

Our House is a residential care home providing accommodation and personal care to five people with learning disabilities at the time of the inspection. The service can support up to 5 people.

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

Right Support:

People were not always supported to have maximum choice and control of their lives and staff were not always supporting people in the least restrictive way possible. The service could not always demonstrate they were acting in people's best interests.

People were not always protected from the risk of harm as staff did not always receive appropriate training to support people in safe, consistent and effective ways.

Right Care:

People were supported by staff who knew them well and who had been safely recruited. People had access to a range of professionals to support them with their needs. However, the care planning was not always up-to-date and reporting requirements were not always being followed.

Right Culture:

The staff was trying to develop an open and empowering culture. People and their relatives knew how to make a complaint and felt confident they would be listened to. However, we found more work was needed to ensure the service was operating in accordance with the regulations and best practice guidance.

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 2 March 2020).

At our last inspection we recommended the provider took steps to support staff in providing their duties more effectively. At this inspection we found the provider had made some improvements, but further improvements were needed.

Why we inspected

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.

The inspection was prompted in part due to concerns received about safeguarding processes. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements.

We found that safeguarding reporting and recording processes were not always being followed. The support provided was not always following best practice guidance. Monitoring and auditing systems were in place but were not always sufficient.

You can see what action we have asked the provider to take at the end of this full report.

The provider has taken some effective action to mitigate the risks, but further improvement is required.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Please see the safe, effective, caring, responsive 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 Our House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the consistent provision of person-centred care, adequate staffing, and governance at this inspection.

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

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.

Since the last inspection we recognised that the provider had failed to send statutory notifications to CQC. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

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.