Wickham Road

About the service

Wickham Road is a residential care home providing personal care to 2 people at the time of the inspection. The service can support up to 4 people.

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

Right Support

The provider had acted to make improvements that were required after our last inspection. People now received care and support in a safer, cleaner environment because staff followed current practice in relation to infection prevention and control. The environment was well-equipped and well-maintained and met people’s sensory and physical needs. People received support with their medicines to achieve the best possible health outcome. Staff supported people to have the maximum possible choice, control and independence and they had control over their own lives.

Right Care

The service now had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

The provider had improved their monitoring and oversight of the service since our last inspection. They had provided additional resources and support to the service to make and maintain improvements that were required. Staff placed people’s wishes, needs and rights at the heart of everything they did. The service enabled people to work with staff to develop the service. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 24 March 2021). 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

We carried out an unannounced inspection of this service on 6 November 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 safe care and treatment, staffing 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.

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 Wickham Road 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.

Wickham Road is a residential care home providing accommodation and personal care to up to four people over the age of 18. At the time of the inspection, two people were using the service. The service specialises in supporting people with a learning disability, autism or with needs relating to their mental health.

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

People did not always experience a service that was safe, because the provider was not taking all reasonable measures, including following all aspects of the relevant national guidance, to protect them from the risk of being infected with COVID-19.

The service is required to have a registered manager in place to ensure that people who use services have their needs met and that the regulated activity is managed by an appropriate person. At the time of the inspection the service manager was not yet registered with CQC and the service had not had a registered manager for six months. We did not have full assurance that there was sufficient leadership and oversight of the service. This increased the risk that people may not receive high quality, safe care in line with best practice guidance.

There were care plans, positive behaviour support plans and risk assessments in place for people however, these were not routinely updated following incidents of challenging behaviours or with any changes since the Covid-19 pandemic. Staff had access to these documents and were able to respond to a person’s general needs and understand the person’s likes and dislikes.

There was no evidence that the provider’s quality checks were robust enough to identify areas that may require improvement

Other aspects of the service were safe.

Medicines were managed safely at the service. There are audits in place to monitor the temperature and the stock of medicine. Staff knew when to administer PRN (‘as required’) medicines to people in the event this was required.

People were placed at risk from contracting infection. This was due to insufficient systems to ensure the service was compliant with national guidance specifically relating to the risk management of Covid-19. Following the inspection, the provider submitted proposals to develop systems and processes to minimise these risks.

Internal quality assurance checks were ineffective and were not an accurate record of findings in the service. Following these audits, there was no evidence of plans to make improvements where it was needed.

The service had an open, person-centred culture which meant people felt supported and listened to.

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. This was a focused inspection which meant we only looked at two domains, Safe and Well-led rather than all five domains.

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 (Inspection on the 17th of June 2019, published on the 17th of July 2019)

Why we inspected

The inspection was prompted in part due to concerns received about medicines, staffing and general practice within the service. As a result, we undertook a focused inspection to review the key questions Safe and Well-Led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

Enforcement

We have identified breaches in relation to safe care and treatment, in particular infection control, staffing, and good governance 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.

Wickham Road is a residential care home that accommodates up to four people. The service specialises in supporting people with learning disabilities and those with autistic spectrum disorders. At the time of our inspection there was one person receiving care and support and the service also provided respite care.

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 autism 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

People had active lifestyles, but they did not always have opportunities to meet people and develop friendships. People’s choice of activity was not always met as staff did not have the skills to support people to go swimming.

The provider was not meeting the Accessible Information Standard and the provider has told us they will take steps to make information more accessible for people using the service.

People told us they felt safe using the service. The provider had appropriate risk assessments in place with guidance for staff about how to mitigate risks. The provider supported people to take their medicines safely. People were supported to maintain a clean and tidy home.

The provider met people's nutritional needs and supported them to make healthy food choices. People were supported with their physical and mental health needs and care records contained good information on these. People were supported to attend all necessary healthcare appointments to ensure their healthcare needs were met.

People told us the registered manager and the staff were kind and caring and knew people using the service well. People's choices were respected in relation to their daily care and support and staff supported people to be active and involved in all parts of their care. People's privacy and dignity was maintained.

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.

There were quality assurance systems in place to ensure care and support were kept to a good standard. The service worked with a range of healthcare and multidisciplinary professionals to achieve good outcomes for people.

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

Why we inspected

This was a planned inspection in order to provide the service with a rating.

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.