London Road

Updated 18 January 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.

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

The inspection was carried out by 1 inspector and an 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

London Road 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. London Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service also provides care and support to people living in a ‘supported living’ setting, so they can live as independently as possible. People’s care and housing are provided under separate contractual agreements at this setting. CQC does not regulate premises used for supported living; we looked at people’s personal care and support.

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. On the first day of the inspection, we sought consent from people in supported living to visit them on 7 December 2022.

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 spoke with 8 people who used the service and observed people interacting with staff. We spoke with 5 people's relatives. We received feedback from 5 professionals about their experience of the care and support provided by the service. We saw recommendations made by Headway following their approved provider assessment visit to the service in October 2022.

We spoke with 12 staff including the provider’s brain injury rehabilitation operations director, operations manager, registered manager, an administrator, 2 senior support workers, therapy coordinator and 5 support workers.

We reviewed a range of records. This included people's care records and records of incidents and accidents. A variety of records relating to the management of the service, including the service’s action plan and recent audits were reviewed.

Updated 18 January 2023

About the service

London Road is a residential care home providing accommodation and personal care to up to 10 people. The service also provides personal care to 3 people in 1 ‘supported living’ setting. The service supports people living with acquired brain injury. At the time of our inspection there were 12 people using the service.

London road is a large adapted building with 10 bedsit-like ‘flats’ with ensuite bathrooms. Communal facilities included an adapted kitchen, living room and adapted bathroom. There was a passenger lift to the first floor, allowing wheelchair access, a laundry, activity and storage rooms. People in supported living had their own bedrooms and shared the kitchen, dining, bathroom and living rooms. There was a staff office/sleep-in room within the house.

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

People’s risks had been assessed and their support plans detailed the actions staff should take to keep them safe. Individual risk assessments and support plans were reviewed regularly, and timely action was taken when people’s needs changed. Staff followed advice from professionals when managing risks in relation to choking, pressure care, seizures and medicines. People’s medicines were reviewed regularly to ensure they remained suitable. The registered manager had ensured the equipment people needed was available and appropriately maintained. Provider policies were followed to manage environmental risks including fire and control of infection.

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.

When people were unable to consent to any restrictions needed to keep them safe, capacity assessments had been completed and applications to deprive them of their liberty had been submitted. Each person had a named staff member [keyworker] who supported them with planning and decision-making. Improvements had been made to staff recruitment, employment conditions and training to address staffing challenges and ensure staffs’ approach maximised people’s choice, control and independence.

The provider and registered manager were committed to ensuring improvements underway at the service were completed. Increased investment, oversight and leadership, recruitment changes, staff training and support were all having a positive impact on the service's culture. Effective working relationships had been established with health and social care professionals. Feedback from people and their relatives had been acted upon. People’s comments included, “I love it here” and “It is cool so far”. A relative said, “I am grateful.”

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 06 May 2022) and there were 3 breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 23 and 24 February 2022 and 01 March 2022. 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 safe care and treatment, safeguarding service users from abuse and improper treatment and good governance.

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 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 has changed from requires improvement to good. 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 London Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.