7 November 2023
During an inspection looking at part of the service
Harvey Lane is a residential home providing personal care to up to 8 people with a learning disability and/or autistic people. At the time of our inspection there were 6 people using the service. Accommodation was provided on the ground floor, with each bedroom having ensuites. There was a communal lounge, dining room, and sensory area.
People’s experience of using this service and what we found
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.
Right Support:
People did not have full control and choice over their lives. This was because staff practice did not empower people to be independent and systems to ensure they were listened to were not effective. People were not supported to have maximum choice and control of their lives and staff 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. We were not assured people were receiving effective 1-1 or 2-1 staff support as required. People were not supported with their health care needs because staff did not always seek external professional support in a timely manner and when required. People were not supported to manage risks to themselves and from the environment. This placed people at risk of harm.
Right Care:
Incidents were not used to support staff learning and ensure people were receiving the right support. We were not assured staff understood how to support distressed behaviour and their support had contributed to incidents of distressed behaviour occurring. This placed people at risk of harm. People’s living environments did not promote their dignity. The support provided was not fully person-centred because staff were not following people’s care plans and these were not updated when needs changed.
Right Culture:
Governance systems in the service were ineffective as they had failed to ensure regulatory requirements were met. Leadership was weak and staff had not received effective support. Improvements to the culture were needed in order to ensure people received effective person-centred support.
We raised our concerns with the provider during the inspection. The provider took immediate action to address the risks within the service. We identified some initial early improvements between our first and second visit.
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 8 August 2017).
Why we inspected
The inspection was prompted in part due to concerns received about the management of risk to people’s safety, medicines, and staffing. A decision was made for us to inspect and examine those risks.
Following our first visit to the service we raised our concerns with the provider. We returned on a second day to check they had taken action to address the immediate risks. We found the provider had taken effective action to make initial improvements.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, staffing, deprivation of liberty authorisations, person-centred care, and good governance.
Please see the action we have told the provider to take at the end of this report.
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, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.