Background to this inspection
Updated
24 June 2020
Background to this inspection
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 Care Act 2014.
Inspection team
Two inspectors carried out this inspection.
Service and service type
Loretta House is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our visit the registered manager was taking a period of pre-arranged leave. The deputy manager was present during the inspection process.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from commissioners. The provider was not asked to complete a provider information return prior to this inspection. This is the information we require providers to send to us to give us some key information about the service, what the service does well and improvement they plan to make. We took this into account when we inspected the service and made judgements in this report.
During the inspection
We spoke with six people who used the service about their experience of the care provided. We spoke with four members of staff including the provider, deputy manager and two care workers.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification and further evidence from the provider in relation to placements in the service of people whose primary diagnosis may not be learning disabilities.
Updated
24 June 2020
About the service
Loretta House is a residential care home providing personal care and accommodation for up to 10 adults with learning disabilities. Six people were living there at the time of the inspection.
Loretta House is a three-storey detached home. People have their own bedrooms and share two lounges and a large kitchen/dining area. A rear patio leads onto a small garden area. Toilet and shower facilities are shared. All people living at Loretta House require support with personal care.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support for people with learning disabilities although we found the provider was not aware of the publication of these principles. Registering the Right Support ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
There were deliberately no identifying signs, intercom, or cameras to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. 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.
A person whose care needs were not in line with people with learning disabilities had been admitted to Loretta house. This person’s basic needs were met at the time of the inspection although the provider recognised it would be unlikely, they could meet their needs on a long term basis. The provider had not completed an assessment of how this placement would impact on their ability to continue providing a service that was in line with the principles of Registering the Right Support. The policies and systems in the service required improvement to reflect accurately best interests’ meetings to support this practice.
People’s experience of using this service and what we found
The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People were care for by skilled staff who knew how to keep them safe, protect them from avoidable harm and meet their needs. People had their risks assessed and staff had support and training to manage risks safely. People’s medicines were managed and stored safely. Staff followed infection control and prevention procedures.
People’s needs were assessed and updated on an ongoing basis. Staff we were trained to ensure that they could meet their needs. People were supported to have as much independence as possible and efforts were made to offer support in the least restrictive ways. Policies and systems were in place to support this.
People were supported by staff who were caring and kind in their manner and knew them well. People’s privacy and dignity were respected and maintained.
People’s needs were met, and the service adapted to changes in their needs. Staff were provided with the information and training needed to offer person centred care and had knowledge of people’s health needs.
The quality of the service offered to people was monitored by the management although not always consistently. The management team were approachable and had an open-door policy. People knew and liked the management team. The management team and staff established good linked with relevant professionals and community services.
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 27th July 2017).
Why we inspected
This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make further improvements. Please see the well lead section of this full report.
You can see that action we have asked the provider to take at the end of this full report.
We found no evidence during the inspection that people were at risk of harm from this concern. Please see the ‘well lead’ section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Loretta House on our website at www.cqc.org.uk.
Enforcement
Since the last inspection we recognised that the provider had failed to update the commission of its statement of purpose.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.