50 Burton Road

50 Burton Road is a care home providing personal care and accommodation for up to six people. At the time of the inspection there were five people living there. People living at the service had learning disabilities.

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.

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

Quality assurance systems had failed to fully implement and embed actions to ensure people’s care was sufficiently monitored. Risks were not always accurately assessed and planned for and people were not always protected. Care plans were not always fully reflective of people’s needs; however, staff knew people well. Some people had missed medical appointments as systems were not effective. Infection control measures were not always consistently applied which could pose a cross infection risk.

People were supported by enough staff, although staffing levels varied. Medicines were managed safely. Lessons were learned when things went wrong. People were protected from abuse by staff who knew how to recognise and report concerns. People and staff were engaged in the service. Relatives and staff felt there had been many improvements to the service since the new registered manager started. The provider acted upon their duty of candour responsibilities.

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 good (published 20 March 2018). At this inspection, there had been a deterioration and safe and well-led were rated requires improvement. There were no breaches of regulations.

Why we inspected

We received concerns about people’s safety and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has deteriorated to requires improvement overall. This is based on the findings at this inspection.

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.

We have identified breaches in relation to people not always being protect from risks and systems are not always effective at identifying areas to improve.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We inspected this service on 13 February 2018 and the inspection was unannounced. At our previous inspection in January 2016, the service received an overall rating of Good. At this inspection we found the service remained Good.

50 Burton Road is a care home located in Burton on Trent, Staffordshire and is owned by Voyage 1 Limited. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

50 Burton Road is registered to provide a care home service without nursing for up to six people with learning disabilities and associated conditions in two adapted buildings.

50 Burton Road met the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

50 Burton Road is a care home that comprises of two houses that are located next door to each other in Burton on Trent. There are three bedrooms in each house. There is an adjoining internal door from one house to the other. At the time of our inspection six people were using the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager oversaw the running of the home and was supported by a deputy manager, senior support workers and support workers.

People’s individual needs were met as there was enough staff to support them. People were supported to keep safe and the staff understood their role in protecting them from the risk of harm. People were supported to take reasonable risks to enable them to live as independently as possible. To ensure people’s safety was considered, environmental risks were assessed and managed. People were supported to take their prescribed medicine and systems were in place to ensure this was done safely. Checks were undertaken on staff prior to employment to establish that they were suitable to work with people. The service was kept clean and systems were in place to guide staff on the prevention and control of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People and their representatives were involved in their care; which enabled them make decisions about how they wanted to receive support in their preferred way. People were supported to eat a balanced diet that met their preferences and assessed needs, and access healthcare services. People received coordinated support to ensure their preferences and needs were met.

Staff knew people well and were considerate and caring towards them. People’s privacy and dignity was respected and upheld by the staff team and people were supported to maintain relationships with those who were important to them.

People were supported develop and maintain interests and be part of their local community. The registered manager and staff team included people and their representatives in the planning of care. There were processes in place for people and their representatives to raise any concerns about the service provided.

A positive culture was in place and people and their representatives were consulted and involved in developing the service. Staff had a good understanding of their roles and responsibilities and were supported by the registered manager. The registered manager and provider understood their legal responsibilities with us and systems were in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.

50 Burton Road provides personal care for up to three adults with a learning disability and associated conditions. There were three people living at 50 Burton Road on the day of our inspection.

There was no registered manager in post at the time of our inspection. The previous manager had deregistered in December 2015 and the provider was in the process of recruiting for a new manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People were protected against the risk of abuse, as checks were made to confirm staff were of good character and suitable to work in a care environment. There were sufficient staff available to support people. Medicines were managed safely and people were supported to take their medicine as prescribed.

Staff had knowledge about people’s care and support needs to enable support to be provided in a safe way. The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005. Staff knew about people’s individual capacity to make decisions and supported people to make their own decisions. People’s needs and preferences were met when they were supported with their dietary needs and people were supported to maintain good health.

The delivery of care was tailored to meet people’s individual needs and preferences. People were supported to develop and maintain hobbies and interests both at home and in the local community to promote equality and integration. The provider actively sought and included people and their representatives in the planning of care. There were processes in place for people to raise any complaints and express their views and opinions about the service provided. There were systems in place to monitor the quality of the service to enable the provider to drive improvement.