Archived: Stanway Close and Greenway Road

Updated 16 December 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.

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

Stanway Close and Greenway Road is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Stanway Close and Greenway Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 there was not a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we wanted to be sure the person would be at home so we could meet them and observe staff supporting and communicating with them. We also wanted to make sure the manager and staff would be available to support the inspection and have time to speak with us.

Inspection activity started on 21 October 2022 and ended on 18 November 2022. We visited the home on 2 November 2022.

What we did before inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed all the information we had received about the service since it was registered with us. We discussed the development of this service with the provider’s regional manager and we also sought feedback from the local authority commissioning and safeguarding teams. We used all of this information to plan our inspection.

During the inspection

We met the person using the service. They were not able to talk with us about their service. Staff told us they did engage with people they knew well and trusted, so we observed staff supporting, interacting and communicating with them. We also spoke with two relatives to gain their views of the care and support provided.

We spoke with two members of care staff. We also spoke with the manager and a registered manager from another service who was supporting the home.

We reviewed a range of records. This included the person’s care records. We looked at one staff file in relation to recruitment. A variety of records relating to the management of the service, including quality audits, fire safety checks, fire drills, fire risk assessment, legionella risk assessment and first aid supplies checks were viewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The manager sent us quality audits, a medicine audit, a health and safety audit, infection control audits and the infection control policy, staff training and supervision records and staff meeting minutes which we reviewed.

Updated 16 December 2022

About the service

Stanway Close and Greenway Road is a care home providing personal care to one person who is autistic and has a learning disability. They received care and support 24 hours a day from a small team of four staff.

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.

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

The service was not fully able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

The service had been through a period of significant change during 2022. It had previously supported six people in two adjoining properties (known collectively as Stanway Close and Greenway Road). Due to one property requiring extensive repairs and renovation, five people had been supported to move to other services which met their needs. This service now only supported one person in the Greenway Road property and the provider had applied to change their registration to reflect this.

It was clear the person’s emotional wellbeing had suffered badly due to the loss of their trusted staff team and the recent temporary move to another service. The current staff were working hard to support the person to go out and re-establish old routines to enhance their quality of life. Photographs demonstrated that the person had once led a very active life and it was hoped they would again.

They were supported by staff to be involved in decisions about their care and support. Staff used communication methods which were personal to the individual to enable them to express themselves. Family members had not felt fully involved. They had not always been listened to or worked with collaboratively to develop and improve the service.

The provider had not treated all concerns and complaints seriously. Relatives told us they had raised concerns about their family member’s care and support over a significant period of time. They did not feel listened to and did not feel their concerns had been acted upon.

The person being supported had choice and control over their life. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The person received personalised care and support which was currently being built around their changing needs and preferences. They had a new, small staff team who they were getting to know and building trust in.

Staff were trained to support the person, who was relaxed with the staff who supported them. Staff supported the person with their medicine in a safe way.

Right Care

The person's care and support plan did not accurately describe the care being delivered by staff or the person’s chosen lifestyle. The new staff team were developing a good understanding of the person's needs and were flexible to enable them to meet changing needs and wishes.

The person did not take part in activities or pursue interests outside of the home as they once had. The service gave the person ongoing support to try once loved activities that had previously enhanced and enriched their lives.

The person received kind and compassionate care. Staff protected and respected the person's privacy and dignity. Staff were understanding and were getting to know the person so they could respond well to their needs.

The person was kept safe from avoidable harm because the service had a clear policy to support staff to recognise and report abuse or poor care. Staff spoken with said they would be confident to report any concerns about possible abuse or poor practice. Relatives had no concerns about the person's safety.

The person who had individual ways of communicating, using body language, sounds, signs and pictures interacted comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

Staff had not been well supported until the current manager had started working in the home. There was ongoing training and supervision for staff to make sure practice always followed best practice guidelines.

Right culture

The person and those important to them were now involved in planning their care. Family members told us they had not been fully involved in their loved one’s life and felt that the previous management team had not been approachable or effective. This was now improving and they were being listened to.

The person had not been supported by an effective management team. The provider had failed to consistently assess, monitor and improve the quality of the service. Rather than being able to develop and flourish, the person had suffered a significant decline in their quality of life. The new management team were working hard to improve all aspects of the service and build a new staff team. Relatives had regained some confidence in the management of the home and in the provider following these changes.

The person was supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities the person with a learning disability and/or autistic the person may have. This meant the person received compassionate care from a staff team who were building a trusting relationship with them.

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

Why we inspected

This inspection was prompted by a review of the information we held about this service. This service was registered with us on 8 February 2021 and this is the first inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have made one recommendation in relation to supporting the person to rebuild their self confidence. We have identified a breach in relation to record keeping and quality monitoring 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. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.