Archived: Venetia House

Venetia House is a 12-bed residential home providing personal care to 11 people at the time of the inspection. The care home supports people in an adapted building.

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

We have made a recommendation about the development, regular review and implementation of service policies and procedures.

People told us that they were happy living in the service and staff were kind and caring.

People did not always receive their medicines as prescribed. Risks associated with people's care had been identified and mitigated. Measures were in place to reduce the risk of infection. Accidents and incidents were reviewed.

Systems and processes were in place to protect people from abuse and people told us they felt safe. There were enough staff to meet people's needs and staff were recruited safely. There was a clear system in place to monitor the quality of the service. Quality audits were conducted, and the manager and provider had oversight of the service.

People and relatives spoke positively about the care provided and people were supported to stay in contact with their loved ones.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, Right Care, Right Culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of Safe and Well-led the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, Right Care, Right Culture.

We observed people led conversations with care staff on what activities were occurring and when they would take place. Staff interactions were respectful, and staff never overpowered the situation, promoting the people’s involvement in conversations and decision making. People told us they were happy in their home and with who they lived with.

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 requires improvement (published 5 March 2021) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 28 September 2020. 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 relating to safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed following this focused inspection and remains requires improvement. This is based on the findings at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Venetia House on our website at www.cqc.org.uk.

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.

Venetia House is a 12-bed residential home providing personal care to 11 people at the time of the inspection. The care home supports people in an adapted building.

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

At the last inspection, the provider was in breach of a number of regulations. This inspection reviewed three of these regulations to establish whether improvements had been made.

There wasn’t sufficient oversight of the systems in place to keep people safe. This is a continued breach of regulation 12 (Safe care and treatment) and continued breach of regulation 17 (Good Governance).

People were supported to have maximum choice and control of their lives and staff supported them in their best interests; the policies and systems in the service did support this practice.

The provider did not have effective oversight of the safety and quality of the service. Risks to people had not consistently been mitigated. We identified concerns around fire safety, PRN (as required) protocols and risk assessments.

The provider had not maintained effective oversight of staff practice. Staff mandatory training was allowed to lapse and staff supervisions had not always been carried out.

Some improvements were required to the recruitment process to ensure staff were recruited with robust checks. Criminal record and barring checks were completed. There were enough staff available to meet people's needs, the service had recently experienced a high turnover of staff. A person living in the service told us, “Staff are changing all the time”, but added, “I get treated very well”.

People and their relatives spoke positively of the staff and management team. A relative told us, “It’s brilliant, it’s a real home from home, it’s a really good place”. Staff demonstrated a person-centred approach to care that supported choice for people.

Care records reflected people's health and social care needs. There was evidence of partnership working with professionals to support people's healthcare needs.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

The service was homely and the building looked and felt like a home. People received a lifestyle based on their choice and preferences and were well-matched socially, so were compatible and formed good personal relationships with each other. The provider and manager knew every person they cared for and knew what was important to them. A number of staff had completed training in Autism Awareness, Mental Health Awareness & Positive Responses. However, policies and procedures needed to be updated, so staff practice could be informed by the most up to date guidance. Inspectors signposted the provider to STOMP (STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines) pledge and psychotropic medicines policy and to the new Restraint Reduction Network standards in staff training.

The provider had addressed the issues identified in previous inspections in relation to safeguarding service users from abuse and improper treatment.

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 requires improvement (published 3 September 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an announced focused inspection of this service on 7th August 2019. 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 safe care and treatment, safeguarding service users from abuse and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed remained the same, requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for on our website at www.cqc.org.uk.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safety and managerial oversight of the service 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.

Venetia House is a 12-bed residential home providing personal care to 12 people at the time of the inspection. The care home supports people in an adapted building.

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 life outcomes for themselves that include control, choice and independence.

The care service has been developed and designed in line with 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.

People did not always receive safe care and were not always protected against financial abuse.

Health and safety checks on the building were not regularly completed to ensure risks to people’s safety were minimised. We brought health and safety issues to the attention of the manager on the inspection visit where we had immediate concerns to people’s safety. They contacted us following the inspection detailing changes and improvements they had arranged to meet these safety concerns. There were no adequate infection control checks in place which resulted in a heightened potential for cross infection and cross contamination of infections.

There was little consistent evidence that any quality monitoring had been undertaken. The audit systems that were in place were not operated or overseen by the provider to ensure people received a quality service. Staff had limited access to policies and procedures to enable them operate systems effectively and protect people in the home.

Staff recruitment procedures were adequate which ensured people were cared for by staff who had been assessed as safe to work with them. Medicines were stored and administered safely. Staffing levels were adequate to provide good levels of care.

The provider had effective systems in place to assess the needs of people prior to being admitted to the home. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood the Mental Capacity Act 2005 (MCA). Staff had supervision from the manager to ensure they met people’s needs. There was enough staff on duty to respond to people’s health and care needs.

People were provided with a varied menu which met their dietary and cultural needs. Staff promoted people’s privacy and dignity.

People’s needs were assessed, and they were encouraged to develop their independence skills, which allowed people to move out of the home to independent living. Staff had concentrated on increasing peoples social care, pastimes and independence which were seen as positive areas of change and had a positive effect on people’s outlook.

Care plans provided information for staff that identified people’s support needs and any risks to their safety and well-being. There was a complaints process in place and management had responded to complaints.

Staff had considered people’s end of life choices and made reference to this in care plans.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted in part due to concerns received about allegations of financial irregularities. A decision was made for us to inspect the home but not look at the allegations and incidents that were subject to Police and Local Authority investigations.

Enforcement

We have identified breaches in relation to the safety of people in the service and safety and monitoring of the environment they live in. 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.

Venetia House is a residential home which provides care to people with mental health needs. It is registered to provide care for up to 12 people. At the time of our inspection there were 11 people living at the home.

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 and associated Regulations about how the service is run.

People using the service we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

People's risk assessments had provided staff with information of how to support people safely.

People using the service told us they thought medicines were given safely and on time.

Staff had been subject to character checks to ensure they were appropriate to work with the people who used the service.

Staff had been trained to ensure they had skills and knowledge to meet people's needs, though training on some important issues had not yet been provided.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives. However, this had not always been carried out.

People had plenty to eat and drink and everyone told us they liked the food provided.

People's health care needs had been protected by referral to health care professionals when necessary.

People told us they liked the staff and got on very well with them, and we saw many examples of staff working with people in a friendly, supportive and caring way.

People and their representatives were involved in making decisions about care, treatment and support.

Care plans were individual to the people using the service and usually covered their health and social care needs.

There were sufficient numbers of staff to ensure that people's needs were responded to in good time.

Activities were in place to provide stimulation for people and people took part in activities in their chosen community activities.

People told us they would tell staff if they had any concerns and were confident that proper action would be taken.

People and staff were satisfied with how the home was run by the registered manager and the management team.

Management carried out audits to check that the home was running properly to meet people's needs, though not all essential systems had been audited.

People were involved in the reviewing of their care plans which they signed. People we spoke with told us they were happy living at Venetia House and said they received the support they needed from the staff. People told us about their lives and told us how staff helped and supported them. We observed that people who used the service and staff had a positive professional relationship and that people throughout the day approached staff for support when they needed it.

People were supported by staff that knew them well and were employed in sufficient numbers and were supported to access community resources, in some instances people who used the service received additional funding so that they had one to one support with a member of staff. People who had one to one support told us they used this time to access services within the community.

We found records to be in good order, which included records regarding people who used the service, staffing and maintenance records.

People we spoke with and records we read showed people were supported to take an active part in community events and activities, which included voluntary work and being, involved in art and performance projects. People also told us they had been on holiday either to Skegness or Ibiza. People told us they were supported to make decisions about their day to day lives. People spoke positively about living at Venetia House and told us that staff were supportive.

People told us they were involved in the development and reviewing of their care plans and that they attended resident meetings. One person told us: - 'I find the resident meetings quite useful.' A second person when asked about their involvement in their care plan told us: - 'Staff sit with me and we go through it regularly, I'm happy with what's written about me.'