Our House

Updated 29 February 2024

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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Our House 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. Our House 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 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 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

We met and spoke with 6 people living at Our House, 6 care staff, 1 agency staff member, 2 maintenance staff, a team leader, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

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 also spoke with 2 relatives who were visiting and received additional feedback from 2 relatives following the inspection visit and from 3 health and social care professionals.

We looked at records relating to people’s care and the management of the service. This included 3 care plans and associated risk assessments, medicine administration records (MARs) and staff recruitment and training records.

We also asked the service to send us records relating to the management of the service, quality assurance audits and policy documents. This information was reviewed in detail after the site visit.

Updated 29 February 2024

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.

About the service

Our House is a residential care home providing personal care to 8 people with a learning disability or autistic people at the time of the inspection. The service can support up to 8 people.

People’s experience of using this service and what we found

Right Support

People were not supported in a safe, clean, warm and appropriately maintained environment. Risks identified by the fire service and other external safety consultants had not been promptly addressed. Fire doors were propped open with wedges, and flooring was in need of replacement and presented trip hazards in the service’s communal spaces. On the first day of our inspection the service was cold and dirty.

Risks in relation to people’s individual behaviours had not been appropriately identified and mitigated.

In response to feedback during the first day of inspection the provider took action. By the second day of the inspection the service had been cleaned, was noticeably warmer and additional risk assessments had been developed.

Medicines were stored securely; however medicine administration records had not been accurately completed.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. We have made a recommendation in relation to systems for recording assessments of people’s capacity in relation to specific decisions.

Right Care

The service was short staffed and staff and managers were having to complete additional shifts to ensure people’s safety. Necessary recruitment check had not been completed and a third of the staff team had completed less than 50% of the training identified as necessary to meet people’s needs.

Staff understood people’s individual needs and communication preferences. People were confident approaching staff for support and did so without hesitation. Staff supported people to access healthcare services when required.

Staff understood how to protect people from abuse. There were systems in place to ensure people were protected from the risk of financial abuse.

Right Culture

The providers quality assurance systems were ineffective and had failed to ensure prompt action was taken in response to identified safety concerns.

Staff were complimentary of the registered manager and records showed staff had received regular supervision. The roles and responsibilities of the registered manager and nominated individual were understood by staff.

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 good (published 1 April 2020).

Why we inspected

The inspection was prompted in part due to concerns received about medicines, staffing levels, staff training, safeguarding and the oversight of the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe, effective and well-led only. 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 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 and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Our House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the premises, risk management, staffing, recruitment and governance at this inspection. In addition, we have made a recommendation in relation to the assessment of people’s capacity.

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 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.