Vicarage Road (B)

Vicarage Road B is a residential care home providing personal care to up to 6 people. The service provides support to people with learning disabilities, autism and physical disabilities. At the time of our inspection there were 6 people using the service.

The care home accommodates 6 people in one adapted building. The home is on one level enabling people to mobilise around the building at ease.

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 had not always been supported safely with their medicines. Improvements were needed in the guidance around ‘as required’ medicines and in considerations when thickeners were added to medication. Staff had enabled people to access specialist health and social care support in the community. 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.

Right Care:

People had not always been supported to take part in activities and pursue interests based on their preferences. People had not been supported to develop goals and aspirations based on their interests. The provider had enough staff to meet people’s needs and staff received training around people’s needs. However, checks had not consistently been carried out on staff competencies following training. Staff understood how to protect people from poor care and abuse. The provider worked with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right Culture:

People had not always been involved in daily decisions about their care nor had people always been involved in developing or reviewing their care plans. The provider did not have effective systems to monitor the quality and safety of the service. This included ineffective systems to monitor safety concerns, people’s health needs and to make necessary improvements in the service. The management team began to make improvements within the service during the inspection and sent information of further planned improvements following the inspection.

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 27 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focussed inspection to review the service. During the inspection we identified concerns relating to the care and support people were receiving so we widened the scope of the inspection to a comprehensive inspection reviewing all 5 key questions.

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. Please see the safe, effective, caring, responsive and well led sections of the full report.

Enforcement

We have identified breaches in relation to person centred care, safe care and treatment, staffing and in the systems to monitor safe and good quality care at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider and will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

People remained safe using the service. Staff understood how to protect people from harm. People’s risks were assessed, monitored and managed to ensure they remained safe. Processes were in place to keep people safe in the event of an emergency such as a fire. People were protected by safe recruitment procedures and sufficient numbers of staff were available to meet people’s care needs. People received their medicines as prescribed. Staff understood their responsibilities in relation to hygiene and infection control.

People continued to receive effective care. People received care from staff that had the skills required to support them safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to eat nutritionally balanced meals. People had access to healthcare professionals, when needed to maintain their health and wellbeing. Staff promoted people’s independence.

People continued to receive a service that was caring. People were supported by staff who knew their care and support needs. People’s rights to privacy and dignity were respected by staff.

People continued to receive a service that was responsive to their individual needs. Care records were personalised and contained details about people’s preferences and daily routines. People were supported to pursue hobbies and activities that interested them and processes were in place to respond to any issues or complaints.

The service continued to be well led, the registered manager understood their role and responsibilities and staff felt supported and listened to. People and staff were encouraged to give feedback, and their views were acted on to enhance the quality of service provided to people. The provider worked in conjunction with other agencies to provide people with effective care.

People's needs were assessed to establish the care that they needed and care was planned and carried out to meet those needs. Staff knew people well, understood how people communicated and interacted with them continuously.

We found that people were cared for in a clean and hygienic environment. We looked around the home and saw that communal areas, bedrooms and bathrooms were clean and tidy. People were protected from the risk of infection because appropriate guidance had been followed. An infection control policy was in place and was recently updated. Staff followed the organisation's procedures that were in place for cleaning the home.