Stubblefields House

Updated 12 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.

Inspection team

One inspector carried out this inspection.

Service and service type

Stubblefields House 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 CQC. 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

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before 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 all of this information to plan our 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.

During the inspection

We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, the manager, and three care workers. We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 12 February 2022

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 the Care Quality Commission (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

Stubblefields House is a residential care home providing personal care and accommodation for up to ten adults or older people with a learning disability and/or autistic spectrum disorder. There were ten people living at the service on the day of the inspection. The service was not supporting anybody in the community at the time of inspection.

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

Systems were not effective to assess, monitor and improve the quality and safety of the service. The lack of systems meant the provider had failed to identify and address the concerns we found at this inspection.

Measures were not in place to mitigate the risk of the spread of infection. The service was not always clean and tidy and some areas of the environment required improvement. The provider acted during the inspection to improve infection control measures.

People were at risk of avoidable harm because risks to people had not always been identified, assessed and mitigated.

There was insufficient staff deployed which impacted on the cleanliness of the service and people’s ability to access the community. The management team were consistently working on shift which impacted their abilities to carry out their roles. The provider was actively recruiting staff.

People did not always receive individualised care and were not always fully supported to continue their hobbies and interests during the pandemic.

People received their medicines as prescribed but best practice was not always followed. We have made a recommendation about this.

Recruitment procedures were in place, but these had not always been followed. We have made a recommendation about this.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People and their relatives shared positive feedback about the service. We received positive feedback about the management team and staff felt supported. It was clear people had developed positive relationships with staff and the management team.

This service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. This included people’s environment been restricted due to been used as a staff sleep area and a office in a communal corridor. People had not been supported to maintain hobbies and interests during the pandemic. The provider told us they would be working with the local authority to review individuals needs and support.

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 of this service was good (published 10 January 2018)

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about visiting procedures. A decision was made for us to inspect and examine those risks.

We inspected and found there were concerns with infection control, person centred care and governance, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, responsive and well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. 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.

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 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 risk management, infection control, person centred care and governance at this 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.