28 February 2022
During a routine inspection
People’s experience of using this service and what we found
People told us they felt safe and enjoyed living at the service; their comments included, “I am very happy where I am and wouldn’t change anything.” Relatives gave the same positive feedback.
Some aspects of medication management were not always safe. We found improvements were required in the management, recording and auditing of medication used to thicken drinks for people who were at risk of choking and of creams prescribed to manage risks to people’s skin integrity. We have made a recommendation in relation to the management of thickeners and prescribed creams.
The service did not have a registered manager. Although there was a temporary manager in place and a permanent manager had been recruited, we found effective oversight had not always been maintained in some areas of the such training, supervision and quality of audits. We have made a recommendation in relation to the implementation of effective quality assurance processes.
Risks to people’s care were assessed and managed well. Some areas of moving and handling risk assessments required further detail.
The service followed safe recruitment practices and we found enough staff were available to support people. The service frequently used agency staff to ensure adequate staffing levels and the provider told us they were in the process of recruiting more staff.
At the time of our inspection, the provider was following current guidelines in relation to infection prevention and control, visiting and vaccination as a condition of deployment.
The provider completed person-centred assessments and care plans were updated when required. People were supported to access relevant healthcare services when they needed them, and they were supported to eat and drink well.
Staff’s training and supervision was not always up to date but the provider told us about their plans to ensure this was addressed in the short term. Staff told us they felt well supported in their roles. People and relatives told us staff were knowledgeable and skilled.
People were supported by staff who were caring and respectful. People, relatives and when appropriate, advocates, were involved in making decisions about the care people received.
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. 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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. There was a person-centred culture at the service. Support provided promoted people’s choice and control. Communication plans had been developed to ensure staff communicated well with people. There was adapted equipment at the service to meet people’s needs and promote their independence. We observed positive interactions between people and staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 31 July 2019 and this is the first inspection.
The last rating for the service under the previous provider was Good (published 27 June 2018).
Why we inspected
This was this service first inspection since it had registered under a new provider on 31 July 2019.
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. This included checking the provider was meeting COVID-19 vaccination requirements in place at the time of our inspection.
Recommendations
We have made two recommendations. We recommended the provider review the management of thickeners and prescribed creams and we recommended the provider implement effective audits.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.