Background to this inspection
Updated
24 May 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 Care Act 2014.
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
Two Inspectors carried out the inspection
Service and service type
L'Arche Bognor Regis Jericho is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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. The manager was on leave and the community leader supported the inspection.
L’Arche website states, “We believe that people with learning disabilities have much to teach us and contribute to the world. During the last fifty years, we have learnt that one of the best ways to enable this is by creating Communities with a culture of shared lives between people with and without learning disabilities, from which we can work together to build a more human society.” This community ethos was apparent throughout the inspection and was reflected in staff job titles.
Notice of inspection
This inspection was unannounced
What we did before inspection
We reviewed information we had received about the service since registration with CQC. 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection
During the inspection
We spoke or communicated with six people who used the service and three relatives about their experience of the care provided. People who were unable to talk with us used different ways of communicating including Makaton, pictures, photos, symbols, objects and their body language. We spoke with five members of staff including the community leader, three assistants and one live in assistant. A live-in assistant was defined on L’Arche website as, “Supporting people with learning disabilities. Along with one or two other assistants, … live with a small number of people with learning disabilities in their home”. We spent time observing the support and communication between people and staff in shared areas of the house.
We reviewed a range of records. This included three people’s care records and six medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.
Updated
24 May 2022
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
L'Arche Bognor Regis Jericho is a care home providing accommodation and personal care for up to six adults with learning disabilities and/or a variety of associated health and support needs. At the time of inspection, the service was supporting six people. People live in one large house.
People’s experience of using this service and what we found
Right Support
The service didn’t always provide people care and support in a safe, clean or well-maintained environment. Governance systems were not always effective and had not always identified or managed concerns. For example, kitchen hygiene standards were not formally monitored or checked and this shortfall increased the potential risk of harm to people. The community leader provided assurances of their improvement plans. There were shortfalls with managing risks in the environment and we have made recommendations about the management of the premises to support people to stay safe.
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. We observed people participating in a variety of individual and group activities of their choosing. People and relatives told us staff supported people to take part in activities and pursue their interests in their local area. A visiting professional told us about how staff engaged with people to participate in activities and how the pandemic had impacted on opportunities. They told us, “Hopefully the houses will start mixing again, it’s good for everyone. It's a wonderful organisation and I admire the [staff] greatly”.
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs with genuine regard for the person. A relative said, “The house is a wonderful place, the staff are wonderful people and they think the world of [the person]”. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. A relative told us how staff had supported their loved one with an interest in music, “Staff had thought it would be a good idea for [person] to work on their music”. The persons skills and enthusiasm continued to develop and resulted in them being able to sing happy birthday to a loved one.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People and relatives told us they felt safe.
Right culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. L’Arche Jericho operated a community shared lives model where ‘Core members’ (People) were respected and supported to live a quality life of their choosing.
Staff knew and understood people well and placed people’s wishes, needs and rights at the heart of everything they did. We saw people offered opportunities and choices within a collaborative culture based on respect and inclusivity.
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 February 2018)
Why we inspected
We undertook this focused inspection to assess that the service is applying the principles of Right support right care right culture. We have found evidence that the provider needs to make improvements. Please see the safe and well led section of this full report.
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 a breach in relation to governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.