17 March 2022
During a routine inspection
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
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.
Improvements had been made since the last inspection and the service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. However, improvements were still needed in some areas.
Right support
Medicines were not always managed in a safe way and in line with guidance. The registered manager made sure immediate improvements were made after our inspection to keep people safe. Staff did everything they could to avoid restraining people. However, the service did not always properly record when staff restrained people, and the provider did not share learning in this area. The registered manager had identified this as a problem and was working to put things right. People felt safe at the service and with the staff who supported them. Staff focused on people's strengths and supported people to enjoy fulfilling and meaningful lives. People were encouraged to be as independent as possible. Staff supported people to identify and achieve their goals and aspirations. People were involved in planning their care and had opportunities to give feedback about the service. Staff managed risks well to keep people safe while promoting their independence.
Right Care
The provider's recruitment procedures needed more checks to help make sure only suitable staff were employed. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff protected and respected people's privacy and dignity. Staff understood their responsibilities in protecting people from abuse and were confident any concerns they raised would be acted upon. People had access to staff support when they needed it. This included allocated one-to-one support hours, which people could choose how they used. People had opportunities to take part in activities they enjoyed and to pursue their interests.
Right culture
The provider's governance arrangements were not always effective in keeping people safe and ensuring good quality care and support. The provider did not identify the issues we found during our inspection. Staff valued people's individuality, protected their rights and enabled them to lead confident, empowered lives. 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. The registered manager and staff had established effective relationships with other professionals to ensure people received the care and treatment they needed.
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 last rating for this service was inadequate (published 17 September 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in most areas. However, there was still improvements to be made and the provider remained in breach of some regulations and the service is now rated requires improvement.
This service has been in Special Measures since 17 September 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 inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe 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 and Recommendations
We have identified three continuing breaches in relation to the management of medicine, the recruitment process and how the provider makes sure the service is safe and well led.
Please see the action we have told the provider to take at the end of this report.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.