Background to this inspection
Updated
16 February 2022
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 completed by one inspector.
Service and service type
New Street 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. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
The people receiving support did not have verbal communication and we were told they could become distressed when introduced to new people. Respecting this, we spoke with three people’s relatives to gain their feedback on the care provided. We spoke with five members of staff including the registered manager and nominated individual.
We reviewed a range of records. This included five people's care records. We looked at three staff files in relation to recruitment. We also looked at a variety of records relating to the management and quality assurance of the service.
Updated
16 February 2022
About the service
New Street is a residential respite care home providing personal care to people who have learning disabilities or autistic spectrum disorder. The service can support up to 2 people for short stay respite care.
People's experience of using this service and what we found
We found the provider had not sent Deprivation of Liberty Safeguards (DoLS) authorisation requests. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). In addition, we found some people did not have a completed mental capacity assessment.
Staff had received training in the Mental Capacity Act however, further improvement was required to enable staff to fully understand how to work within the principles of the Act.
We raised the issue with DoLS requests and improvements to training with the provider and they confirmed DoLS requests would be issued and refresher MCA training provided for staff members.
The provider had developed a range of audits and quality assurance checks however improvements were required due to issues found during the inspection not being identified by the provider.
People were comfortable, relaxed and happy around care staff and staff understood how to keep
people safe.
Staff understood who to report concerns to as well as the risks to people's health.
Staff had very good knowledge and understood people's health conditions and the support they required.
The risks to people's health were reviewed regularly and care plans updated following any changes.
Safe recruitment and background checks were carried out prior to staff commencing employment.
People received their prescribed medications safely and in accordance with their specific guidance.
People were supported to attend appointments with healthcare professionals and guidance was sought.
Staff followed the infection control procedures the provider had in place.
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 able to demonstrate how they were working towards meeting the underpinning principles of Right support, right care, right culture, however improvements were required in relation to maximising people’s choice, control and independence due to issues around DoLS identified during the inspection.
Right support:
• Model of care and setting maximises people's choice, control and independence
Right care:
• Care is person-centred and promotes people's dignity, privacy and human
rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This is the first rating of this service. The service was registered with us on 19 September 2019.
Why we inspected
This was a planned inspection as the service had not previously received a 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.
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 monitor the service.
We have identified breaches in relation to Regulation 13 (Safeguarding service users from abuse and improper treatment), at this inspection. The provider responded to the concerns on the day of the 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.