1 Charmandean Road

Updated 24 June 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.

This inspection was in part triggered to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 10 (Dignity and Respect) 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

Two Inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

1 Charmandean Road 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.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post. The provider had arranged for an experienced manager to provide direct support to the service to drive improvements.

Notice of inspection

This inspection was unannounced

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 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

We spoke or communicated with eight people who used the service and five relatives about their experience of the care provided. People who were unable to talk with us used different ways of communicating including Makaton, symbols, objects and their body language. We spoke with seven members of staff including the operations director, the health and wellbeing manager, the Positive Behaviour Support (PBS) lead, the interim manager, deputy manager and support workers. We spent time observing the support and communication between people and staff in shared areas of the house.

We reviewed a range of records. This included three people’s care records and three medication records. 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. We spoke with two professionals who regularly visit the service.

Updated 24 June 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 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

1 Charmandean Road is a residential care home for people living with a learning disability and autistic people. It is registered to provide personal care for up to eight people. People live in one large house. There were eight people living in the care home at the time of inspection.

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

Right Support

People and relatives told us staff supported people to pursue their interests. Staffing levels had improved and this had increased opportunities for people. People told us they were going out more frequently and there were more staff that could drive which had meant people were supported to consider a wider range of activities. One person told us, “I had been swimming which I hadn’t done in ages”. Staff had adopted new approaches; We observed people smiling and happy, engaged in various activities with staff. People were being supported when they experienced emotional distress. Staff had continued to develop their knowledge and used agreed approaches to support people. People received care and support in a safe, clean environment and some areas of the service had been redecorated with plans for more to follow. It was evident that improvements had been made since the last inspection and people were seeing the changes as positive. Managers and staff acknowledged more improvements were needed. This included ensuring incidents involving people were analysed to ensure staff continued to consider techniques and strategies to reduce the frequency and impact of incidents. This would also ensure staff were consistent with each person’s support.

Right Care

We observed people receiving kind and compassionate care. Relatives spoke positively about improvements in the service. One told us their loved one, “Is happy and settled ... I want the best for [person] “and commented on how things had improved, they told us “I have seen the difference”. Staff protected and respected people's privacy and dignity. Managers and staff had a better understanding how to support people who may lack capacity to understand the consequences of choices they made. Staff required more learning about communication and the approaches and tools to use with people in order to create and implement effective communication plans. Senior managers had scheduled additional training for staff to further develop their skills and knowledge. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People and relatives told us they felt safe.

Right culture

People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Following the last inspection, the provider had recognised the substantial need to improve the quality of the service people received. They had ensured senior managers with the appropriate expertise were focused on improving the service with clear actions planned. We observed people being supported by staff in a respectful and caring way, staff told us they were valued by senior managers and spoke positively about the interim manager who was leading by example. Staff had a better understanding of people’s sensory needs and ongoing work with Positive Behaviour Support (PBS) assessments had provided staff with techniques and tools which supported people when they experienced episodes of distress. People, relatives’ staff and visiting professionals have all commented on the openness of managers and the drive to improve the culture within the service. Managers and staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 25 March 2022). At this inspection we found improvements had been made and the provider was no longer in breach of regulations. This service has been in Special Measures since 25 March 2022. 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

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture. This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We carried out an unannounced comprehensive inspection of this service on 17, 18 and 20 January 2022 breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person-centred care, dignity and respect, safe care and treatment, safeguarding, staffing and governance.

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, effective and well led sections of this full 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.