Archived: Patrick Court

Patrick Court is a supported living service that can accommodate 7 people living in their own homes on one site. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. There were 2 people receiving personal care at the time of our inspection.

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

Right Support

There was enough staff to meet people's needs, however there was a reliance on the use of agency staff which meant that people did not always receive their care from staff that knew them well.

People were supported to maintain contact with their relatives. Staff enabled and encouraged people to take part in activities, which they enjoyed doing and helped them to experience new recreational activities. People were encouraged to develop new skills and have active and fulfilling lives.

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.

Periods of anxiety or emotional distress were recorded, which included the action taken by staff to support people. The registered manager considered these as part of the review process of people's needs.

Right Care:

Care plans had not always been updated to reflect peoples current needs, however staff were aware of the support people required to meet their needs.

Staff understood how to protect people from poor care and potential harm. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Staff supported people to access health and social care support, which included a regular review of their prescribed medicines. Staff supported people with their medicines safely. Positive relationships had developed with local health care providers, who provided timely support, considering people’s emotional and sensory needs for planned appointments.

Right Culture:

There were systems in place to monitor the quality and standards of the service, however these had not always been effective at identifying areas for improvement.

Peoples care was regularly reviewed to ensure the care provided met their current needs. People’s dignity and human rights were promoted, and people were encouraged to make decisions about their day to day routines.

Staff felt well supported and said communication was effective and the management team were visible and always available to discuss any concerns. However, a relative told us that they did not feel management were responsive and did not always address concerns raised.

Staff were safely recruited. All staff received an induction and ongoing training to ensure they could meet people’s needs. Staff received training and information relation to the management and best practice guidance for infection prevention and control.

The staff worked well with external agencies and health and social care professionals, in supporting people with their ongoing care and support needs.

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 04 April 2020.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 13 February 2020. A breach of legal requirements was 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.

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, Responsive 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 Requires Improvement to Good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Patrick Court is a supported living service providing personal care to seven adults with a learning disability and/or autism.

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 autistic people 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

Risk assessments were not always up to date and care plans did not accurately guide staff how to support people safely.

Advice from professionals to improve people’s environment was not always implemented in a timely way.

Frequent changes to staffing and management structures meant people did not always receive consistency of care.

People’s care plans detailed their strengths and promoted their dignity and independence. Their communication needs were assessed and recorded in detail and staff were observed appropriately interacting with people.

People took part in activities they enjoyed and were supported to access the community. Visitors were welcomed. The home had good relationships with health and social care professionals. People had a healthy, varied diet and ate food they enjoyed.

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.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was Outstanding (published 17 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement and recommendations

We have found a breach in relation to safe care at this inspection.

Please see the action we have told the provider to take at the end of the full

version 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.

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.

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 and senior management team at Patrick Court were visible, approachable and acted as a role model for staff within the service. There was a clearly articulated person centred culture. Staff were encouraged and enabled to work creatively which achieved consistently outstanding outcomes for the people receiving care and support. There was a strong system of quality assurance led by the provider and registered manager that ensured people consistently received exceptional care and support.

The people receiving care from Patrick Court had an enhanced sense of well-being and quality of life because staff worked innovatively to enable people to have meaningful experiences and to become active members of the local community.

Staff were empowered to work creatively and to develop positive therapeutic relationships with people. Staff were proud of the support that they provided to people and the positive outcomes that they had observed. People had been supported to make their accommodation a home that they were comfortable living in.

Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS) and had applied that knowledge appropriately. People were supported to make decisions for themselves and their consent in relation to their care was actively sought by staff. People were supported to use communication aids and information was provided to people in an accessible format to enable them to make decisions about their care and support.

The people supported by Patrick Court had complex needs and people who demonstrated behaviour that may challenge services received care that was based upon best practice guidelines that met their individual needs and successfully reduced instances of incidents within the home.

People were at the heart of the service and staff were committed to enabling people to live full, varied and fulfilled lives. People were supported in creative way to continue to achieve their aspirations and continued to have new experiences. Staff were motivated to find innovative ways to remove barriers for people to achieve have meaningful access in the community.

Staff demonstrated the provider’s values of offering person centred care that respected people as individuals in all of their interactions with people. People, their relatives and the professionals involved in people’s care consistently told us that the service consistently achieved exceptional outcomes for people.

People could be assured that they would be supported by sufficient numbers of staff. A number of people within the home received care from staff on a one to one basis and records showed that people received the this care in the way they needed to maintain their safety.

People’s health and well-being was monitored by staff and they were supported to access health professionals in a timely manner when they needed to. People were supported to have sufficient amounts to eat and drink to maintain a balanced diet.

Staff understood the importance of obtaining people’s consent when supporting them with their daily living needs. People experienced caring relationships with staff and good interaction was evident.