SCASS Ltd Also known as Blossom House

SCASS Ltd is registered to provide accommodation with personal care for up to eight people with a learning disability and/ or autistic people, people with a physical disability and younger adults. At the time of the inspection, one person was staying there as a permanent resident and they had people who regularly stayed for short respite.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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

Right Support: People were encouraged to be independent where they could to provide self-fulfilment in people’s lives. Staff were always on hand to keep people safe and offer support at any time.

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.

Right Care: People’s care was designed around them, staff respected people as individuals and enjoyed spending time with them and getting to know them. Staff understood the importance of being understanding and patient with people. Staff through providing consistent support built trusting relationships with people using the service through the words used and their actions. Staff demonstrated they were there to ensure people’s safety and recognised abuse and how to report it.

Right Culture: The culture of the service was focused on providing a welcoming and safe environment for people using the service. People were regularly observed in a way that was non-intrusive, and staff who were working with them shared updates with management to ensure people always received the best care to help people live a happy and fulfilled life.

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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 20 September 2019) and there were breaches of regulations. 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.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

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

SCASS Ltd is registered to provide accommodation with personal care for up to eight people with a learning disability, autistic spectrum disorder, a physical disability and younger adults. At the time of the inspection, one person was staying there as a permanent resident and another person was on a short-term respite break.

The service had not been fully 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 did not always 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

People’s healthcare associated risks were not always identified, assessed and mitigated. People were not always supported with medicines management by staff who were appropriately trained, and their competency assessed. People and staff did not have access to hand wash products. The provider did not have effective systems to learn and share lessons from accidents and incidents. Staff recruitment records had some gaps.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People were not supported by staff who received enough training and regular supervision.

People’s needs in relation to their protected characteristics were not always recorded in their care plans. People’s care plans were not personalised, and people did not always receive care that was personalised to their needs. The provider’s auditing, monitoring and quality assurance systems were not effective in identifying issues and driving improvement.

The service didn’t always 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 fully reflect the principles and values of Registering the Right Support as people’s care was not personalised.

People and relatives told us they felt safe with staff and there were enough staff on duty to meet their needs. Staff understood safeguarding procedures and when and how to escalate concerns. People and relatives told us staff understood their likes and dislikes and were supported by staff who were caring and respected their privacy. People were supported by staff to remain as independent as possible. People and relatives were satisfied with the complaints process. They told us they were happy with the service and found the management approachable.

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 24 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified five breaches in relation to person centred care, need for consent, safe care and treatment, staffing and good governance 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 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.

This unannounced inspection took place on 29 December 2016. The provider met all legal requirements we checked at our last inspection in September 2013.

The service had a registered manager in place. 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 service had a very homely and welcoming feel, and staff knew people and their support needs very well. People had care plans to which they were encouraged to contribute, and staff were aware of the requirements of the Mental Capacity Act 2005 and what this meant for the people who used the service.

Staff were aware of their roles and the leadership of the service was clear in its vision, values and aims. Staff supported people to undertake a wide range of activities and there were always enough staff, who had been properly vetted before they started work, to ensure people could undertake the activities of their choice.

People were supported to eat nutritious foods and access health care services when required.

Staff kept people safe and the service had a robust system of risk assessments and strategies in place to support people safely. People with specific medical conditions had plans and guidelines in place to address these.

Staff supported people with complex communication needs to communicate effectively.

We found that there were daily log sheets kept for people whilst they used the respite service. The logs verified that there were two people at a time looking after one person on three different respite occasions between June and September 2013. We found one incident logged and action taken following the incident. We spoke to four staff who had worked in the respite service and they all confirmed that there had been one incident.

Representatives of people who used the service were happy with the service. One said, 'Thank you, to you all for your support. I know X was happy, safe and inspired by being with you all."

We found that care was assessed before people started using the respite service and appropriate information regarding any care alerts were recorded. Risk assessments were individual and monitored by staff.

There were regular staff meetings, and staff felt that they had support from the manager and senior staff. People and relatives were involved in planning care. Both parents and people who used the service were happy with the service. One person said, "they are very good."

We found that there were no complaints or safeguarding incidents since the Blossom House opened in 2012. Staff had received training about safeguarding and were aware of how to report any concerns to the local authority.