14 June 2023
During a routine inspection
Telegraph Road is a small residential care home providing personal care for up to 4 people. The service provides support to people who live with learning disabilities and autistic people. At the time of our inspection there were 4 people using the service.
People’s experience of using this service and what we found
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.
Right Support: The service was not maximising people’s choices, control or independence. People were not always 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 always support this practice. We could not be assured the service was working within the principles of the Mental Capacity Act 2005 (MCA). We have made a recommendation about this.
Right Care: People were not always treated with dignity and respect and were not supported to lead inclusive and empowered lives. People had care plans in place. However, these were not always written in a way that was person centred and easy to understand; we found a lack of detail to guide staff on how to support people safely and consistently. People were at increased risk of harm because staff did not always have the information, they needed to support people safely. Medicines were not always managed safely. We were concerned people were not always safe from the risk of financial abuse. We have made a recommendation about this.
Right Culture: The service was not always well led. The quality assurance systems to assess and monitor the service were not always in place, and where they were, they were not always effective. We found the provider did not have enough oversight of the service to ensure it was being managed safely and quality maintained. Quality assurance processes had not identified all of the concerns in the service. Records were not always complete, or person centred. This meant people did not always receive high quality care. However, the provider was responsive throughout the inspection and took prompt action to address the concerns. There is a new manager, deputy manager and regional manager in post who implemented an action plan and introduced new processes and systems. These processes and systems need time to become embedded within the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 1 December 2020, and this is the first inspection.
The last rating for the service under the previous provider was good, published on 29 December 2017.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 and Recommendations
We have identified breaches in relation to assessing risk, medicines management, dignity and respect, person centred care and management oversight.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.