26 April 2023
During an inspection looking at part of the service
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.