Archived: Choice Support - 5 Bowley Close

Updated 9 March 2023

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

The inspection was carried out by one inspector.

Service and service type

Choice Support – 5 Bowley Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Choice Support – 5 Bowley Close 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

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. However, they were temporarily not overseeing the service and did not take part in the inspection.

Notice of inspection

This inspection was unannounced. We visited the service on 6 January 2023. We continued to gather information up until 26 January 2023.

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

Due to the conditions and disabilities of people using the service people were not able to give an account of their experiences of care. We carried out observations of people’s support and interactions with support workers. We spoke with the regional operations manager, two interim home managers who were temporarily managing the service, and 3 support workers.

We reviewed a range of records. This included three people’s care and medicines records. We looked at 5 staff files in relation to recruitment and supervision. We also looked at policies and procedures and records related to the management of the service. After the inspection we spoke with one relative of a person using the service and we received feedback from three health and social care professionals.

Updated 9 March 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Choice Support - 5 Bowley Close is a residential care home providing personal care that accommodates up to four people. The service specialises in supporting people with learning disabilities and those with autistic spectrum disorders. At the time of our inspection there were 3 people receiving care and support.

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

Right support

The model of care did not maximise people’s choice and independence and people were not always protected from the risk of harm. Risks to people were not always identified and mitigated. People’s medicines were not always managed safely. The provider’s systems did not ensure staff received a suitable induction, ongoing support and training to ensure they had the skills and abilities to meet people’s needs. Some staff showed a lack of understanding about people’s support guidelines which placed people at risk.

Right Care

People’s care was not always person-centred. Staff did not always support people with all of their cultural needs. There was limited information about how people were being supported to pursue interests and hobbies and people were not supported to acquire/maintain daily living skills. There was a lack of support towards aspirations and goals.

People’s home environment was not always a reflection of their personal preferences. Not all people had been supported to personalise their rooms and some communal areas were being used as storage. The service did not make reasonable adjustments for people to be fully involved in discussions about their care and support. Staff did not always support people to make decisions. Information for and about people was not presented in ways that facilitated people’s understanding and involvement.

Right culture

The provider did not ensure people using services lead confident, inclusive and empowered lives. People and those important to them were not asked for feedback in order to develop the service. The provider had identified many shortfalls with the service and made many improvements in a short period of time. However, they had not identified all the issues we found with, risk management, medicines, fire safety, and staff training and further improvements were required to ensure people received safe and compassionate care.

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 6 November 2020).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risks. This inspection was carried out to seek assurance that people were being protected from harm.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive 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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Choice Support – 5 Bowley Close on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified breaches in relation to person-centred care, consent to care, risk management, medicines, staffing and good governance. Please see the action we have told the provider to take at the end of this report. We have also made a recommendation in relation to recruitment checks.

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

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.