Archived: Richardson Partnership for Care - 2/8 Kingsthorpe Grove

Richardson Partnership for Care 2/8 Kingsthorpe Grove is a residential home registered to provide personal care and support for younger adults with learning disabilities or autistic spectrum disorder. The home can support up to 18 people, and at the time of inspection 18 people were using the service. The accommodation consists of two adapted houses with shared access to one another; one house has ten bedrooms and the other eight bedrooms. Each house has its own living space, kitchen area and garden.

The service's building had not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. 18 people were living at the service, and this is larger than current best practice guidance. However, the care and support people received ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People told us they felt safe living at the service. However, we found concerns in relation to safe medicine administration and infection control. Systems in place to monitor the quality and safety of care were not robust enough to identify the issues we found, and people were placed at possible harm from poor practice as staff did not always follow the guidelines and policies in place.

The providers systems in place for oversight of the service were not consistently carried out or effective to provide quality assurance. Since the inspection, the registered manager has told us the current audits in place will be discussed amongst their team and reviewed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the systems in the service did not always support this practice. The provider had not evidenced Best Interest meetings had taken place where people did not have capacity to make decisions about their care or treatment. This had been identified prior to our inspection and the registered manager told us meetings were being planned.

People had detailed, personalised risk assessments and care plans in place. Staff had good knowledge and understanding of the needs for people they cared for. However, systems in place were not effective in ensuring the information in care records was up to date and in line with the current care being provided.

People received care in a kind and caring way, promoting their dignity, privacy and independence. We saw examples of this during our inspection. The provider had systems in place that encouraged and responded effectively to any complaints or compliments from people, staff and those involved with the service.

People were supported to follow healthy nutritional plans and were provided with choice at meal times, respectful of cultural and dietary needs for everyone.

Staff received training to ensure they had the skills to effectively care for and support people using the service. Staff felt supported by the management team and received regular supervision and appraisals.

The service had good links with the local community within which people lived. This promoted social inclusion, equality and diversity for people using the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

We found the service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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 Good (published 20 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment and good 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.

People continued to receive safe care. People were consistently protected from the risks of harm; staff knew how to manage risks, whilst promoting people's rights to take risks. Staff were appropriately recruited and there were enough staff to provide care and support to continuously meet people’s needs.

The care that people received continued to be effective. The staff support, training and professional development systems ensured staff had the right skills, knowledge and experience to effectively meet people’s needs on a daily and long term basis. People were supported to maintain good health and nutrition. The medicines administration systems ensured people consistently received their medicines safely.

People were supported and cared for by staff that showed them kindness and treated them respectfully. People were involved in making decisions about their care, were enabled to access the wider community, and maintain contact with family and friends.

People had individualised support plans in place to enable staff to provide people with the care they needed that was in line with their personal preferences and capabilities. People knew how to raise a concern or make a complaint and the provider responded appropriately to any concerns or complaints.

The service had a positive ethos and an open culture. The registered manager had good oversight and leadership of the service.

We spoke with four people who used this service, they told us staff explained their individual care needs to them and they were asked for their consent before staff provided any care. All of the people we spoke with said they were well looked after at 2/8 Kingsthorpe Grove and the staff knew how they needed and wished to be supported.

All of the people we spoke with told us they had plenty to eat and drink and that the food was good at 2/8 Kingsthorpe Grove. One person said 'We choose the food we want to be on the menu'.

We received two anonymous allegations about the way people were spoken to which were being investigated by the local authority safeguarding team. However during our inspection people told us they liked the staff; that they were kind to them and they felt safe in their care. We also saw that people were comfortable and relaxed within their environment. The staff that we spoke with demonstrated a good understanding of their roles and responsibilities in the safeguarding vulnerable adults.

People we spoke with told us that they were happy living at the home and with the care they received. One person told us 'staff help me keep calm and help me do things'. They said they had meetings where they talked about activities and the food they liked. Another person told us that they helped at the home by getting the milk and papers for the home. They also said 'its lovely here and the staff are nice' and they liked the people living at the home.

People told us that the meals provided by the home were very good and they had a choice of meals and drinks each day. One person told us if they did not like what was on the menu; they could choose an alternative option.