Background to this inspection
Updated
5 December 2019
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
The inspection team consisted of one inspector.
Service and service type
21a Elvetham 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.
The service had a manager registered with the Care Quality Commission. 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 the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the 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. 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 two people who used the service and two relatives about their experience of the care provided. We spoke with four members of staff including the registered manager, team coordinator and support workers. We reviewed a range of records. This included three people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were also 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 one professional who regularly visits the service.
Updated
5 December 2019
About the service
21a Elvetham Road is a residential care home providing personal care to five people living with a learning disability at the time of the inspection. The service can support up to five people.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This 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.
The service was a small service within a bungalow. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Quality assurance tools had failed to identify, implement and sustain improvements at the service in relation to people's care files and risk assessments, fire safety equipment and staff training. This meant we could not be assured people consistently received safe and effective care by staff who had up to date training.
People did not always have opportunities to offer feedback about their experience of care. The service did not consistently apply 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 did not always reflect the principles and values of Registering the Right Support as people's outcomes were not consistently updated to ensure their goals were recorded and staff could support them to achieve these.
People’s care files did not always contain complete information about their health needs and risks. Checks on the home had not consistently been completed to ensure people were supported in a safe environment.
People were supported by sufficient staff to offer flexible care. People were supported to maintain a balanced diet based on their preferences. People were supported to engage in activities they enjoyed inside and outside of the home. People were supported by staff to maintain their privacy when being supported with personal care.
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; the policies and systems in the service supported this practice. People were encouraged to maintain their independence and learn new skills.
People were supported to receive their medicines as prescribed. People were supported to access healthcare professionals as required. People felt able to raise concerns with the staff and management team.
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 Requires Improvement (published 26 October 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made or sustained and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach in relation to the governance of the service 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 meet with the provider and request an action plan following this report being published to understand 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.