Consensus Support Services Limited - Shrewsbury

Updated 4 July 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

This inspection was carried out by 3 inspectors.

Service and service type

Consensus Support Services Limited - Shrewsbury 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. Consensus Support Services Limited - Shrewsbury 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 not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We spoke with 5 professionals who work with the service on a regular basis. 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

During this inspection we reviewed 4 care plans, we spoke with 1 person, and we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 3 relatives and received email feedback from a further 4 relatives. We spoke with 15 staff, including support workers, team leaders and members of the senior management and quality team. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at 3 people’s medicine records and 3 staff files. We also looked at other records used by the service including policies and procedures and maintenance records.

Updated 4 July 2023

Consensus Support Services Limited - Shrewsbury is a residential care home providing personal care to up to 15 people. The service provides support to adults with learning disabilities and autism. At the time of our inspection there were 14 people using the service. The service consists of two properties that are next door to one another and share a driveway. Both homes offer individual en-suite bedrooms and the use of shared communal facilities.

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.

The provider was aware of the principles of Right support, right care, right culture. However, we found areas of improvement were required to ensure the principles were fully realised for each individual.

Right Support:

People were supported by staff who were safely recruited and had received training relevant to their role. Some additional training was required and supervisors told us they wanted to spend more time supporting the new staff.

People’s medicines were not always stored correctly, and guidance was not always where the care plan directed.

People’s records were not always completed fully and there were times when reviews of the records did not happen within the time scales set. People had access to activities, but we received feedback that the activities were limited, and more was needed both in the community and in the home.

Right Care:

Risks to people’s safety were not always considered. We found a number of risks in the environment which the provider needed to address. People were supported by staff who had been trained in recognising abuse and felt confident speaking up on people’s behalf.

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. However, we found some of the paperwork needed to be reviewed to ensure the decisions being assessed were not written as a forgone conclusion even when it was apparent the person lacked capacity in the areas being assessed.

Right Culture:

People were supported by staff who were dedicated to their needs however staff felt better leadership was required. Governance systems were in place, but these were not always effective at highlighting the improvements needed.

The views of stakeholder’s were sourced and the feedback was used to inform future planning. The service did work in partnership with others however we received some feedback to say better dissemination of information was required. The provider was responsive to the concerns raised and has taken action to address the shortfalls.

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 16 November 2019).

Why we inspected

We undertook this inspection following concerns that the overall quality of care was not meeting people’s needs. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements.

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 have identified breaches in relation to the management of risk, people’s medicines and the overall governance of the service 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.