About the service 78 Hoylake Crescent is a care home for up to four people who have mental health needs and learning disabilities. At the time of our inspection, three people with mental health needs were using the service. No one had a learning disability.
The service was owned and managed by a private partnership. They also own another registered care home and supported living services.
People’s experience of using this service and what we found
Some aspects of the service were not safe. There were hazards within the environment which presented a risk for people using the service and staff. We discussed these with the management team so they could address these straight away.
Improvements were needed to the way in which medicines were managed. People received their medicines safely and as prescribed, but there was a risk of medicines being mismanaged because the systems were not robust enough.
There was not always evidence to show that adverse events had been learnt from and improvements made at the service. For example, when there had been instances of verbal or physical aggression there had not always been reflective practice for the staff to consider why this happened and if changes could be made to the service to reduce the risk of these reoccurring.
Records were not always accurate or complete. We found gaps in recording which included incomplete care plans, risk assessments and quality audits.
People were happy living at the service. They were given choices and were able to be independent when they wanted. The provider had offered short term accommodation to people who had gained new skills and moved to more independent settings.
People had enough to eat and drink and were supported to access healthcare services. They planned their own activities, which included attending places of worship, and were supported by staff when needed and when they wanted support.
People liked the staff and had good relationships with them. They felt staff treated them with respect. Staff were well supported and had the training they needed to care for people safely and meet their needs.
There were appropriate systems for dealing with complaints and people felt able to speak up about how they felt. They were asked for their views about the service and these were used to help plan for improvements.
The registered manager was one of the partners. They worked alongside staff to support people. People using the service and staff felt able to speak with the management team and had good relationships with them.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 not providing support to people with learning disabilities or those with autism at the time of our inspection. However, they provided a model of care which maximised people's choice and independence. They provided personalised care which respected people's dignity and rights. They also had a culture where managers worked closely with people to help them develop their skills and work towards their own goals and aspirations.
The management team told us they had not supported people with learning disabilities since our last inspection and the primary purpose of the service was to support people with mental health needs, specifically those people wanting to develop skills to move on to more independent settings or their own homes.
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 rating at the last inspection (published 20 January 2021) was requires improvement. We identified breaches relating to safe care and treatment, good governance and fit and proper persons employed.
At this inspection not enough improvement had been made and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
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.
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.