92 Carlton Road

Updated 2 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed. We were seeking assurance about this decision and to identify learning about the DMA process.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector carried out the inspection.

Service and service type

92 Carlton Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is required to have a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection, the home did not have registered manager as they had recently left. The home had an interim manager in place while the provider recruited a new manager.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the care home to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We reviewed the information obtained from the recent DMA assessment, which included feedback from three relatives. We used all of this information to plan our inspection.

During the inspection

We communicated with three people who used the service about their experience of the care provided. People who were unable to talk with us used different ways of communicating including body language, facial expressions, and signs. We spoke with five members of staff including the interim manager, quality assurance manager and support workers.

We reviewed a range of records including three people’s care records and two medication records. We looked at two staff files in relation to recruitment and staff supervision. We also reviewed a range of records relating to the management of the service, including audits and policies.

After the inspection

We spoke with three relatives. We sought feedback from the local authority. We looked at training data and quality assurance records. We continued to seek clarification from the provider to validate our evidence.

Updated 2 June 2022

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.

About the service

92 Carlton Road is a residential care home providing accommodation and personal care to five people with a learning disability or autism at the time of the inspection. The service can support up to six people.

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

Right Support

¿ The service supported people to have the maximum possible choice, control and independence over their own lives. Staff supported people to pursue their interests, aspirations and goals.

¿ The service gave people care and support in a safe, clean and homely environment that met their sensory and physical needs. People had the option of personalising their bedrooms to reflect their preferences.

¿ The service adopted least restrictive practices supported by appropriate training underpinned by a positive behaviour approach. Each person had a positive behavioural plan that described de-escalation and support strategies that staff had to follow to respond to distress.

¿ People received the medicines they needed to support their health needs. Managers closely monitored the use of any ‘when required’ (known as PRN) medicines prescribed to manage severe distress to ensure they were used appropriately and only as a last resort.

¿ Staff helped people to make decisions using methods that reflected people’s communication styles and preferences.

Right Care

¿ The service had enough appropriately skilled staff to meet people’s needs and keep them safe. The service tried to match staff with people’s preferences to enhance their experiences.

¿ Staff knew people’s individual communication styles well. They knew how to interpret their signs, gestures, behaviours and body language. They ensured people had access to information in formats they could understand.

¿ Staff knew people well and responded to them appropriately and sensitively. People’s care, treatment and support plans reflected their range of needs and promoted their wellbeing.

¿ People took part in activities and pursued interests tailored to them. The service gave people the opportunity to try new activities.

Right Culture

¿ The service had a positive culture that focused on person-centred care and meaningful outcomes for people.

¿ Staff understood the values of the service to keep people safe and well and give them the best care they could in the least restrictive way.

¿ Staff knew and understood people well. They got to know people as unique individuals and personalities regarding this as a key element of person-centred care.

Rating at last inspection

The last rating for this service was Requires Improvement (published 13 November 2020).

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

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed. We were seeking assurance about this decision and to identify learning about the DMA process.

Prior to our visit, we received notification of a specific incident in which a person using the service sustained a serious injury. This incident is subject to further investigation. As a result, this inspection did not examine the circumstances of the incident.

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.