5 December 2022
During an inspection looking at part of the service
St James Mews is a care home providing personal care and accommodation for up to nine people. The service provides support to autistic people and people with a learning disability. At the time of our inspection there were nine people using the service. The service is separated into two separate living parts, Mews 1 and Mews 2. The service was situated behind a secured gate on the same site as another service registered with the same provider.
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.
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 did support this practice. The service was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support
The model of the service did not follow the RSRCRC guidance. However, the provider had a plan in place as to how they are going to mitigate the effects to people in the service and how they were going to remodel the service. The provider had made improvements since the last inspection. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests, for example, one person loved horses and staff supported them to go horse riding regularly. Staff supported people to achieve their aspirations and goals, for example, monthly key worker reviews detailed what aspirations people had and then this was reflected in the following review as a completed action. The provider had made improvements regarding the environment to ensure people were supported in a clean and safe environment. The provider told us they were also continuing to improve other areas of the environment.
Right Care
People’s daily notes were not always being completed and reflective of the care and support people were receiving. The home manager had already identified this as an area that needed improving. However, people received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Relatives gave positive feedback about the staff and the support they give. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The provider had worked hard to ensure people were able to communicate in their preferred way, staff and the provider told us people were less frustrated now they were able to express their choices in a way that suited them.
Right Culture
People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. People and those important to them, including advocates, were involved in planning their care. Relatives told us they were always informed if there were any incidents, accidents or if their relative was unwell. The provider had worked to ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 29 June 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 29 June 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 05 May 2022 and rated the service inadequate. Breaches of legal requirements were found. We imposed a condition on the providers registration for this service which required them to send us updates on the action they were taking to address the issues. The provider was complying with this condition. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St James Mews on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.