Background to this inspection
Updated
16 June 2021
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the warning notice in relation to Regulation 12 ( Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 17 (Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 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
This inspection was completed by one inspector.
Service and service type
Wrekin Cottage - Telford (West Midlands) 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
At the time of this inspection the service did not have a registered manager in post. However, the day to day management of the location was being provided by the provider’s area managers.
Notice of inspection
This inspection was unannounced. However, we gave the service five minutes notice of the inspection. This was because we had to gather information on the home’s current COVID-19 status and the provider’s procedures for visiting professionals.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection.
During the inspection
We spoke with one staff member and a senior regional manager. In addition, we spoke with a representative from a local authority. We looked at several documents relating to the monitoring of the location including health and safety checks.
After the inspection
We continued to seek clarification from the provider to validate evidence found. This included seeking evidence regarding the actions they took to monitor the quality of care people received.
Updated
16 June 2021
About the service
Wrekin Cottage - Telford (West Midlands) is a residential care home that accommodates up to 16 people living with learning disabilities or autistic spectrum disorder. At the time of our inspection there were 16 people living at the home.
People’s experience of using this service and what we found
People were not always safe as the infection prevention and control procedures were not effectively implemented.
The provider did not have effective systems in place to identify environmental issues which could put people at the risk of harm.
The provider did not have effective systems in place to identify and drive good or safe care provision. The management team failed to address all concerns, previously raised with them regarding the quality of service provided for people. The service did not have a registered manager in post at the time of the inspection.
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.
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.
Wrekin Cottage - Telford (West Midlands) was not able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. The care service had not been developed or designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This was because Wrekin Cottage - Telford (West Midlands) provided accommodation for up to 16 people, some of whom were expected to use shared facilities including bathrooms and communal areas.
Wrekin Cottage was located within a 'campus' style location which contained other care homes with day centre facilities also on site. We were told the management team were looking to change the type of accommodation offered to people living there to be in line with right support, right care, right culture guidance. However, no dates or plans for the proposed changes could be provided by the management team we spoke with.
People received their medicines as prescribed. Staff understood how to protect people from the risk of abuse and knew what to do if they suspected something was wrong. The provider followed safe recruitment practices.
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 Requires Improvement (published 29 May 2019).
At the last inspection we found improvements were needed to keep people safe and to effectively monitor the quality of service provided. In addition, we found breaches in safety and quality monitoring. 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 the same breaches. Not enough improvement had been made/ sustained and the provider was still in breach of regulations.
The service remains rated requires improvement. This service has now been rated requires improvement for two consecutive inspections.
Why we inspected
The inspection was prompted in part due to concerns received about the management of the location. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained the same. This is based on the findings at this inspection.
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 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.
Following our inspection site visit the provider took action to mitigate the immediate risks to people.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wrekin Cottage - Telford (West Midlands) on our website at www.cqc.org.uk.
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 keeping people safe and the provider’s monitoring of the provision of care at this inspection.
Please see the action we have told the provider to take at the end of this report.
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
We will request an action plan from 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.