The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Crowthorne Care

Overall: Requires improvement read more about inspection ratings

277 Boston Road, London, W7 2AT

Provided and run by:
Independent Supported Living and Disabilities Ltd

All Inspections

30 October 2015

During an inspection looking at part of the service

The inspection took place on 30 October 2015 and was unannounced.

The last inspection of the service took place on 8 September 2015, where we identified three breaches of Regulation, relating to the management of the service and management of medicines. We issued a warning notice telling the provider that they needed to make improvements to medicines management by 25 September 2015. This inspection was to check the provider had made the necessary improvements to medicines management. The other breaches of Regulation were not inspected on this occasion.

Crowthorne Care is a supported living service (in a shared house) for up to five adults who have a learning disability. The service is managed by Independent Supported Living and Disabilities Ltd, who are part of a larger organisation; Estocare Group. The service is registered to provide personal care. At the time of our inspection five adults lived at the service.

There was no registered manager in post at the time of the inspection. The provider told us they had recruited a person to undertake this role and they were due to start work at the service in mid November 2015. 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 and associated Regulations about how the service is run.

This inspection looked at how medicines at the home were being managed. Four of the five people living at the home received support to take regular medicines. We found that the medicines were stored, recorded and administered safely. The staff had received appropriate training and support to make sure they administered medicines appropriately. Medicine administration records were accurate and up to date. The staff undertook daily audits of all medicines and the manager undertook additional weekly audits. These were recorded.

8 September 2015

During an inspection looking at part of the service

The inspection took place on 8 September 2015 and was unannounced.

The last inspection of the service was on 21 April 2015 when we identified three breaches of Regulation regarding the way in which medicines were managed, the receiving and handling of complaints and governance of the service. The provider wrote to us with an action plan which stated they would have made the required improvements by 4 June 2015.

We undertook this focused inspection on 8 September 2015 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Crowthorne Care on our website at www.cqc.org.uk

Crowthorne Care is a supported living service (in a shared house) for up to five adults who have a learning disability. The service is managed by Independent Supported Living and Disabilities Ltd, who are part of a larger organisation; Estocare Group. The service is registered to provide personal care. At the time of our inspection five adults lived at the service.

The provider told us that the registered manager had left the organisation. A new person had been employed to manage the service. The previous registered manager had not submitted an application to cancel their registration at the time of the inspection and the new manager had not summited an application to register with the Care Quality Commission. 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 and associated Regulations about how the service is run.

There had been improvements to the way in which medicines were managed. However, these were not enough to ensure that people always received their medicines in the safe and proper way.

The provider had reviewed the way in which they received and handled complaints.

The registered manager’s role was to oversee this location and two other registered locations. The registered manager, who was also the nominated individual, no longer worked at the service and the service manager (who worked at the service on a day to day basis) had also left since the last inspection. The new managers in post had not applied for registration with the Care Quality Commission at the time of the inspection.

The provider had not displayed the most recent Care Quality Commission rating of the service at the location or on their website.

There had been improvements to the way in which the provider monitored the quality of the service. However, they had not identified and mitigated the risks of unsafe medicines management.

You can see what action we told the provider to take at the back of the full version of the report.

21 April 2015

During a routine inspection

The inspection took place on 21 April 2015 and was unannounced. The last inspection of the service was on 16 September 2014. At the inspection in September 2014 there were no breaches of Regulation.

Crowthorne Care is a supported living service (in a shared house) for up to five adults who have a learning disability. The service is managed by Independent Supported Living and Disabilities Ltd, who are part of a larger organisation Estocare Group. The service is registered to provide personal care. At the time of our inspection four adults aged between 21 and 25 years old lived at the service. They had learning disabilities and some of them were not able to communicate their needs verbally. This was the first home away from their parents or boarding school for all the young adults living at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. However, the day to day management of the service was carried out by a service manager who was not registered with CQC.

People’s medicines were not stored, managed or recorded appropriately and they were at risk of receiving the wrong medicines or not receiving medicines as prescribed.

Complaints were not always investigated, responded to or learnt from. Representatives of people who used the service did not always feel able to make complaints.

The provider’s systems for monitoring quality did not always identify or manage risks to people’s safety and well-being. The provider did not always seek or act on the feedback of people who used the service, their representatives and staff.

There were appropriate procedures for safeguarding vulnerable people and the staff were aware of these.

Individual assessments had been developed to help manage certain risks.

There were enough staff employed to keep people safe but sometimes there were not enough staff to support people with some of the things they wanted to do.

People’s capacity to consent had been assessed and their choices and preferences recorded.

People had the support they needed to meet their health and nutritional needs.

People using the service had good relationships with staff. The staff treated people with kindness.

People’s privacy and dignity was respected.

People’s individual needs had been assessed and they were supported to meet these needs. This included taking part in a range of activities and learning daily living skills.

There was a friendly and positive culture at the service.

We found breaches of Regulations 12, 16 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

16 September 2014

During a routine inspection

As part of this inspection we visited the home and met two of the four people who lived there. Neither person was able to tell us about their experiences of living at the home, however we observed how they were being cared for. We spoke with an advocate who represented one of the people living at the home. We spoke with four members of staff, including the registered manager. We also spoke with the local authority safeguarding team who had recently carried out a visit to the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

The service was safe. People were cared for by staff who were trained and supported. People’s needs had been assessed and their care had been planned to meet these needs. People were given support they needed with their health, medicines, personal care and finances.

Is the service effective?

The service was effective. The people living at the home had moved there from their family home or residential schools and they had been supported with these transitions. They had individual plans of social activities and education. The staff worked closely with people’s families to make sure they were provided with activities they liked and which were meaningful for them.

Is the service caring?

The service was caring. The staff spoke about how they met individual needs and demonstrated a good knowledge of these. We observed people being cared for in a positive way. Each person’s care plans detailed their preferences and individual needs and there was evidence these had been met. People were able to see medical professionals when needed and their health and wellbeing was monitored by the staff.

Is the service responsive?

The service was responsive. Care plans had been reassessed as people’s needs had changed and the staff were supporting people to manage risks. Where concerns had been identified these had been discussed with other professionals to make sure people were given the support they needed.

Is the service well led?

The service was well led. The registered manager oversaw three different services and a general manager was employed to carry on the day to day running of the home. The registered manager visited the home at least twice a week and met with the staff regularly. There were appropriate systems for monitoring the quality of the service and the staff told us they felt they had the right support and information to do their jobs.