15 June 2023
During an inspection looking at part of the service
Arundel House – Frinton-on-Sea is a residential care home providing personal care for up to 10 people who have a learning disability and/or autistic people. People living at the service may also have a mental health condition. At the time of the inspection there were 8 people living at the service.
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.
This was a targeted inspection that considered the areas of safe, risk, management, and governance. Based on our inspection of these areas we found the provider did not have effective oversight and governance to drive improvement in a timely way and breaches of regulation continued.
People’s experience of using this service and what we found
Since our last inspection the providers management arrangements had irretrievably broken down. Overall quality and safety were not being addressed. This included staffing, training, governance, and risk management which all directly link to a lack of effective leadership.
A refurbishment programme commenced after our last inspection, but this had not been completed and some bedrooms, and other areas of the home, still required urgent attention and renewal to effect cleaning to an acceptable standard. Infection prevention and control measures were not robust, and some areas of the service remained visibly dirty and unhygienic. We had concerns in relation to fire safety. We advised the provider of our immediate concerns after the inspection and they were addressed.
The service was not meeting the underpinning principles of Right support, right care, right culture.
Right Support:
People did not receive the right support to maximise their choice, control, and independence. There were not enough staff to meet people’s assessed needs and commissioned support arrangements. This meant people did not lead fulfilling and meaningful everyday lives. The model of care did not focus on people’s strengths or promote what they could do. Limited information was available about people's aspirations and goals and how staff could support them to achieve these. People did not receive an interactive and stimulating service.
Right Care:
People were not consistently supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support good practice. Gaps in staff training, supervision and competency checks did not ensure people were cared for by staff with the necessary skills, knowledge, and expertise to deliver the right care and support. Care delivered was not person centred and did not promote people’s dignity and independence.
Right Culture:
The culture of the service did not empower people to lead their best life. Leaders and care staff did not demonstrate values, attitudes and behaviours that ensured people at Arundel House led confident, inclusive, and empowered lives. Staff were unable to demonstrate their understanding of 'Right support, right care, right culture' guidance and how this should influence the support people received.
The service had lacked leadership and direction. Governance systems were not operated effectively and failed to identify risk and people were not receiving a safe quality service.
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 2023) and there were breaches of regulation.
The provider failed to complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider had not made enough improvement and remained in breach of regulations.
Since our inspection the home has had a change in management. The home is being overseen by the regional manager. They have shared an action plan with us and a commitment to drive and sustain improvement.
Why we inspected
We undertook this targeted inspection to check whether the Warning Notices we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains inadequate.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arundel House – Frinton-on-Sea on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified continued breaches in relation to staffing levels, staff training, risk management and governance at this inspection.
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 continue to review the providers action plan to understand what they are doing to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for this service is ‘Inadequate’ and the service remains 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 act 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.