Wings

Updated 21 June 2022

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

One inspector completed this inspection.

Service and service type

Wings 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. Wings 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

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.

Notice of inspection

This inspection was unannounced. Inspection activity started on 5 April 2022 and ended on 13 April 2022. We visited the service on 5 April 2022.

What we did before the 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 spoke with three people who used the service about their experience of the care provided. We spoke with four members of staff including the registered manager.

We reviewed a range of records. This included three people’s care records and medication records. We looked at three 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 from the provider and spoke to six staff via email to validate evidence found. We looked at training data and quality assurance records. We spoke with one professional who knew the service.

Updated 21 June 2022

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

About the service

Wings is a residential care home providing personal care to up to six people. The service provides support to adults with a learning disability, autistic people, mental health, physical disability and older people. At the time of our inspection there were six people using the service. Wings is a bungalow, all rooms are single, bathrooms are shared. There is a medium sized garden that is enclosed by a six-foot wooden fence. There is an office and a sleep-in room located in a separate building.

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

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support: Wings is rural in location and to access the community would require access to transport. People were not consistently able to access planned day time pursuits because of a lack of staff who knew people well and could drive. This led to disappointment and sometimes anger for people.

Externally the care home fitted into the surroundings. However, the six-foot fence was not in keeping. Internally the environment had been improved since our last inspection with a newly fitted kitchen and décor throughout. The kitchen was accessible to everyone.

Right Care: People were not always encouraged or supported to become as independent as they could be or have choice and control over their support. One person had their liberty restricted by a locked gate and this led to others being restricted too. People did not receive planned and coordinated person-centred support that was appropriate and inclusive for them. An example being how medicines were managed. Everyone had medicines dispensed to them from one locked cabinet and people were asked to attend and wait their turn.

Right Culture: The values of the newly appointed registered manager are based upon empowerment and inclusivity. Therefore they will challenge the attitudes and behaviours of some of the embedded practices relating to choice and control to enable people to have their best lives whilst being appropriately supported.

People were not consistently supported to have maximum choice and control of their lives and staffing levels impacted upon the least restrictive way possible and peoples best interests; the systems in the service did not consistently support this practice.

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 requires improvement. (Published 1 April 2020) 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 the provider remained in breach of regulations.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

This inspection was prompted by a review of the information we held about this service. 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.

We have found evidence that the provider needs to make improvements. Please see safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wings on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified breaches in relation to staffing levels, person centred care and the service being well led by the provider 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 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.