25 January 2022
During a routine inspection
People's experience of using the service and what we found
People were not always safe because sufficient staffing levels had not been maintained at weekends. People had been supported by more staff during the week and this had helped to maintain their safety and wellbeing.
People had been supported to manage the risks they may experience by staff who had received training to keep people safe from avoidable harm and abuse. People received their medicines as prescribed from staff who had received training in the safe management of medicines.
People's needs had been assessed and staff supporting them had received training to help ensure they could support people effectively. Support for people who experienced anxiety and distress which may present a risk to themselves or others, would benefit from staff having more specialised training in this area. People who were unable to consent to live in the home had the rights upheld, the provider had applied for the appropriate legal authorisations.
People were supported by kind and caring staff. The effort staff made to understand and communicate with people had improved since the last inspection. Some relatives felt there had been big improvements in people's quality of life.
People were being supported to engage in an increased number of activities both inside and outside of the home. Staff continued to explore what people preferred to do.
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.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
The residential model of care meant people did not always have choice and control in their daily lives. There was a lack of choice in relation to the home and who they shared it with. People did not have information in place which detailed their rights and obligations. Lack of space for staff meant staff frequently had to take breaks in people's lounge/dining room. Staff would complete office tasks at the dining tables directly facing people sat in the lounge.
People's dignity was not always upheld due to the lack of access to basic facilities. We raised this with the provider but were not assured by their response that they had fully considered this impact.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection and update
The last rating for this service was inadequate published 10 August 2021 and there were multiple 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 though improvements had been made, not enough improvement had been made and the provider was still in breach of regulations. We have identified breaches in relation to; staffing, premises and made recommendations in relation to training, visiting and activities.
This service has been in Special Measures since 10 August 2021. 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
This was a planned inspection based on the previous rating.
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 noted there had been improvements made but these still need to be fully embedded. We have found evidence that the provider needs to make improvements. Please see the safe, effective, 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.
Enforcement
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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.