Archived: L'Arche Kent Faith House

L'Arche Faith House is a service for up to 5 people with learning disabilities and autism. The service is in a residential area of Canterbury. There is a main house where 4 people live and an annex for 1 person to live with support. L'Arche is a Christian based charity that supports people of all faiths and none in their services. There were four people living at the service when we inspected.

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:

Risks to people had been identified but there was not full guidance in place to mitigate the risks. Environmental risks had not always been identified and resolved to limit unnecessary risk to people.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have.

Staff were recruited safely and there was enough staff deployed to ensure people received the care and support they needed, when they needed it.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. People were supported to play an active role in maintaining their own health and wellbeing.

People had 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. Staff communicated with people in ways they could understand and respond to. The staff gave people care and support in a safe, clean, well equipped, well-furnished environment that met their diverse needs.

People were assisted to achieve their aspirations and goals. Staff focused on people's strengths and abilities to learn and develop new skills. People pursued their interests that they had chosen.

Right Culture:

Quality assurance systems were in place to monitor the service people received. However, they had not identified the shortfalls we found at this inspection in regards risk assessments and risks within the environment.

Staff placed people's wishes, needs and rights at the heart of everything they did. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

Right Care:

People were treated with kindness and care. Staff showed genuine affection in their approach. Staff knew people well. Day to day choices were offered to people and staff demonstrated a good understanding of people. People were encouraged to take an active role with tasks such as making meals and helping around the service. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

People's care, treatment and support promoted their wellbeing and enjoyment of life.

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 9 May 2018).

At our last inspection we recommended that the registered provider reviews the timescales for following up issues identified during quality audits. At this inspection we found some improvements had been made however we found that the provider had not identified risks during quality assurance audits.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of 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.

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 L’Arche Faith House on our website at www.cqc.org.uk.

Enforcement

We will continue to monitor the service and will take further action if needed. We have identified a breach in relation to safe care and treatment and have made a recommendation in relation to governance and 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.

L’Arche Faith House is a ‘care home’. 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. 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.

L’Arche Kent Faith House provides accommodation and personal care. The philosophy of L’Arche is that people with disabilities live in a community. Therefore, some staff members also live in the home. The accommodation is over two floors, with some bedrooms on the ground floor and some upstairs. There is a communal lounge and a large dining room/activities room and a garden to the rear of the home. L’Arche Kent Faith House was previously registered with a different address and was rated as Require Improvement in December 2015.

There was a registered manager at the service. 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.

Quality monitoring systems had not consistently brought about prompt changes to practice where risks had been identified. We found that some temperature checks had not taken place as per the registered provider’s procedures and some food left in the fridge was out of date. The issue of meat temperatures not being recorded had been highlighted in an audit but prompt action had not been taken to check shortfalls had been corrected.

People were kept safe from abuse and harm and staff knew how to report suspicions around abuse. There were sufficient numbers of staff deployed to meet people’s needs and ensure their safety.

People received their medicines when they needed them from staff who had been trained and competency checked. Staff understood the best practice procedures for reducing the risk of infection; and audits were carried out to ensure the environment was clean and safe. The service used incidents, accidents and near misses to learn from mistakes and drive improvements.

People had effective assessments prior to a service being offered. This meant that care outcomes were planned for and staff understood what support each person required. Staff were trained in key areas and had the skills and knowledge to carry out their roles. Staff had been supervised effectively by their manager and their performance appraised. People were supported to receive enough to eat and drink and staff used nationally recognised guidance to ensure people had a balanced diet.

The service worked in collaboration with other professionals such as psychologists and people’s GPs to ensure care was effectively delivered. People maintained good health and had access to health and social care professionals. Environments were risk assessed to ensure people were safe and met people’s individual needs.

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 support this practice. The principles of the Mental Capacity Act were being complied with and any restrictions were assessed to ensure they were lawful and the least restrictive option.

Staff treated people with kindness and compassion. Staff knew people’s needs well and people told us they liked their staff. People and their relatives were consulted around their care and support and their views were acted upon. People’s dignity and privacy was respected and staff encouraged people to be as independent as safely possible.

People received a person centred service that was supportive of their needs. People’s needs were fully assessed and care plans ensured that personal details were carried through to care delivery. There was a complaints policy and form, including an accessible format available to people. Complaints were used to improve the service delivered to people.

There was an open, inclusive and empowering culture that was implemented by effective leadership from the management team. People and staff spoke of a person centred culture that was empowering. The management team understood their regulatory responsibilities.

People, their families and staff members were involved in the running of the service. There was a culture of learning from best practice and of working collaboratively with other professionals and health providers to ensure partnership working resulted in good outcomes for people.