12 and 13 July
During a routine inspection
- There was no risk assessment of the providers premises, and no fixed alarm points in any of the interview rooms.
- Staff did not routinely hold staff alarms to keep them safe.
- At the time of inspection, the service had high vacancy rates.
- Staff did not complete risk assessments for three people.
- Staff did not receive regular supervision and appraisals.
- Managers did not receive sufficient up to date information to have oversight of specific performance areas.
- We observed a planned session with one person that was not carried out by staff in a respectful and supportive way.
- The service did not meet the target time of 18 weeks for seeing people from referral to assessment and assessment to treatment. The South team referral to assessment waiting time was 45 weeks. In the City team referral to assessment waiting time was 21 weeks
- The information management system was burdensome to front line staff. Staff used a mix of electronic systems, with improvements due to take place from August 2022.
However:
- People were protected from abuse.
- People received kind and compassionate care from most staff who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way that could be understood.
- People were involved in managing their own risks whenever possible. Staff developed positive behaviour support plans with people who used the service so that they were aware of any risks they posed to themselves, others or their environment.
- People made choices and took part in activities which were part of their planned care and support. Staff supported them to achieve their goals.
- We observed a multidisciplinary meeting where staff demonstrated strong links with adult social care services and others to meet people’s social care, housing, employment and education needs.
- People and those close to them were active partners in their care. Staff empowered people who use the service to have a voice and to realise their potential. They showed determination and creativity to overcome obstacles to delivering care.
- People were empowered to feedback on their care and support. We saw examples where staff had encouraged feedback using an easy read “we welcome your feedback” form. We also saw an easy read version of “our learning disability vision, making a better future together” that had been co-produced and set out agreed next steps for enabling people to live happy, safe and healthy lives, and to have the same life opportunities as anyone else.
- Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
- Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people. Leadership was good, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment.
- Staff worked with social care providers to ensure care was line with best practice and national guidance. For example, quality standard 101, behaviour that challenges National Institute for Heath and Care Excellence (NICE).