13 July 2023
During an inspection looking at part of the service
Draycombe House is a care home providing accommodation and personal care to up to 6 adults who have a learning disability. The service occupies the ground floor of a large, period building which has been adapted to meet people’s needs. The other floors of the building are separate to the home and used as domestic premises. At the time of our inspection there were 4 people living in the home.
The service is also registered to provide personal care to people living in their own homes in the community. Personal care is help with tasks related to personal hygiene and eating. At the time of our inspection the service was not providing personal care to anyone living in the community.
People’s experience of using this service and what we found
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.
Right Support:
Although people felt safe, some aspects of the safety of the service needed to be improved. People were placed at risk because some risks had not been adequately assessed. The registered manager had not ensured checks were completed on the safety of the premises and equipment. The registered manager arranged for the risk assessments and safety checks to be carried out during our inspection.
The registered manager lacked knowledge of the checks required to be carried out on the premises and equipment. They undertook to seek support to improve their knowledge.
At our last inspection, people did not enjoy fulfilling and meaningful everyday lives because they were not supported to access activities in the community. Following our inspection, the registered manager had introduced opportunities for people to follow activities in the community, which improved people’s quality of life. People told us they enjoyed the activities they followed in the community. One person told us, “We went to club last night, I like going to club.”
People also enjoyed a range of activities in the home. Staff knew how people enjoyed spending their time and gave them support as they needed to follow the activities of their choice.
People had a choice about their living environment and had personalised their rooms. People told us they liked their accommodation.
Staff supported people to access routine and specialist health care services to ensure their health and wellbeing. People were supported with their medicines in a way that promoted their independence and achieved the best possible health outcomes.
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. Staff supported people to make decisions following best practice in decision-making. They communicated with people in ways that met their needs.
Right Care:
People received kind and compassionate care from staff who knew them well. Staff protected people’s privacy and dignity, and treated people with respect. One staff member told us, “Each [person] has their own unique qualities.”
People were protected from abuse. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff knew how to recognise and report abuse.
The service had enough staff to meet people’s needs. People liked the staff and enjoyed laughing and joking with them.
People could communicate with staff and understand information given to them because staff knew their individual communication needs.
Right culture:
At our last inspection we found the culture in the service did not maximise people’s choices or support them to lead fully inclusive and empowered lives. At this inspection we found the culture in the home had improved and people were supported to enjoy a good quality of life.
Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
Staff placed people’s wishes, needs and rights at the heart of everything they did. They knew people well and were responsive, supporting them to live a quality life of their choosing.
People and those important to them were involved in planning their care. Staff knew how to give people choices about their lives and support, and respected the decisions they made.
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 14 June 2022).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection, although we found some improvements had been made, the provider remained in breach of regulations.
At our last inspection we recommended that the provider sought advice about staffing levels to support people’s social needs. At this inspection we found people’s social needs were being met.
The last rating for this service was requires improvement (published 14 June 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.
Why we inspected
We carried out an announced comprehensive inspection of this service on 8 April 2022. 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 dignity and respect, and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.
During our inspection we identified a concern with the safety of the service, so we widened the scope of the inspection to include the key question of safe.
This report only covers our findings in relation to the key questions safe, responsive and well-led.
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 remained requires improvement. 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 Draycombe House on our website at www.cqc.org.uk.
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.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
During our inspection the provider made improvements to the safety of the service.
Enforcement
We have identified breaches in relation to managing risks to people’s safety and monitoring the quality and safety of the service 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 from 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.