Tigh Lenach

Updated 28 May 2021

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.

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

This inspection was undertaken by two inspectors.

Service and service type

Tigh Lenach 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. Tigh Lenach does not provide nursing care.

Notice of inspection

We announced this inspection the day before our site visit, due to the types of behaviour identified through the CQC notifications and to gather more information about risk management to ensure the safety of the inspectors.

What we did before the inspection

We reviewed the information we held about the service including statutory notifications received about key events that occurred at the service and feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with four staff members, including the registered manager, two senior support workers and a support worker. We reviewed five people’s care records and records relating to the management of the service. We undertook general observations around the service and reviewed medicines management processes. The majority of people who use the service were unable to verbally communicate with us and the other person using the service did not wish to speak with us, therefore we could not ask them directly about their experiences of care. However, we did observe interactions between people using the service and the staff.

After the inspection

We continued to speak with the registered manager and seek clarification about the evidence gathered. We reviewed additional documentation relating to the management of the service and we spoke with two relatives.

Updated 28 May 2021

About the service

Tigh Lenach is a residential care home providing personal care to six younger adults living with learning disabilities and/or autism at the time of the inspection. The service can support up to six people.

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

People were protected from the risk of abuse and discrimination. Staff had received training in safeguarding vulnerable adults and were knowledgeable of the policies and procedures in place regarding identifying and reporting possible abuse. There were sufficient numbers of staff to meet people’s needs.

People’s risks were assessed and plans to mitigate them were detailed in care records. People had individualised behavioural support plans and people were supported proactively to prevent the risk of behavioural incidents occurring. When required, safe restraint techniques were used to protect people from harm. The use of these were under continuous review to ensure it remained safe, appropriate and the least restrictive option.

Safe medicines management processes were in place. Staff had supported people to have their medicines reviewed and reduced in line with the STOMP (Stop overmedicating people with learning disabilities) campaign.

Overall safe infection protection and control processes were in place and the risk to people of catching and spreading the COVID-19 virus had been reduced. However, we found some of the provider’s procedures were not in line with current guidance which impacted on visiting arrangements. We continue to work with the provider to seek assurances that their practices are in line with current government guidance.

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.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were involved in the design and delivery of the service. A personalised service was provided which gave people as much choice and control as possible over their care. The staff worked with other healthcare professionals to ensure their practice was in line with people’s best interests and staff were supported people to be as independent as possible.

The registered manager and staff were clear about their roles and responsibilities. Staff reported any concerns appropriately and the registered manager took accountability for the service. The registered manager was aware of their responsibility under the duty of candour. They told us they had an open and transparent approach to their management of the service and would communicate with people and their relatives if mistakes had been made.

There was a comprehensive programme in place to review the quality and safety of the service. Where improvements were identified as being required, these were addressed promptly. There was a drive and dedication within the team to continuously develop and improve the service. The staff were in the process of trialling a number of projects on behalf of the provider to further improve practices and provide a more responsive service focused on improving outcomes for the people using the service.

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 30 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received from Ofsted about one of the provider’s other services regarding unexplained injuries on people using the service and poor joint working with other agencies. We also identified a pattern in the types of notifications CQC received from the provider. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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.