Background to this inspection
Updated
13 April 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.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service did not have a manager registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided. A manager had been working in the service but was not available at our inspection.
Notice of inspection
This inspection was unannounced
What we did before inspection
We reviewed information we had received about the service since the last inspection. We received feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed notifications the provider had sent us. Notifications are sent when a significant event has happened in the service. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service. We spoke with five members of staff including the deputy manager, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included two people’s care records and two people’s medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We received feedback from two professionals.
Updated
13 April 2022
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.
About the service
Gordon Road is a supported living service providing personal care to people living in their own homes. The provider supported people with a learning disability and/or mental health needs. At the time of our inspection they were supporting three people who lived in one shared house.
People’s experience of using this service and what we found
Right Support
• People were supported to live a fulfilling and meaningful life.
• The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.
• Staff enabled people to access specialist health and social care support in the community.
• Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
Right Care
• People received kind and compassionate care. Staff protected and respected people’s privacy and dignity.
• People received personalised care, meaning staff understood and responded to people's individual needs.
• Staff and people cooperated to assess risks people might face.
• People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Right Culture
• The provider demonstrated a commitment to creating a culture of continual improvement that provided good quality care to people. However, the success of this approach had been affected by unstable leadership and quality assurances processes not always being effective. Checks to ensure that staff were suitable to work at the service had not always been completed appropriately.
• Staff knew and understood people well and were responsive, supporting their aspirations to live the life they chose.
• Staff placed people’s wishes, needs and rights at the heart of everything they did.
Staff were not recruited safely. The provider has made plans to address this.
The provider was not always following Government guidance regarding infection control. We have made a recommendation about this and signposted the provider to current guidance. Some improvements were made at the time of inspection and we received assurances that other concerns we found would be addressed promptly.
There were enough staff to support people safely and staff knew people well. Staff received training to manage risks related to people’s care and support. However, we found this could be enhanced to develop a greater and more in depth understanding for staff, by delivering face to face training. We have made a recommendation about this.
Staff had a good understanding of safeguarding people from abuse. People could make choices and had the freedom to live their lives in the way they wanted to.
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.
Quality assurance processes were not always effective in ensuring the safety and quality of the service. The provider was making changes to their quality assurance systems at the time of our inspection.
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:
We carried out a focused inspection in July 2021 (published 7 September 2021) looking at the key questions Safe and Well Led. Both these key questions were rated requires improvement and there were breaches of regulation in relation to safeguarding, safe care and treatment, good governance and a failure to notify CQC of significant events. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Gordon Road on our website at www.cqc.org.uk.
At this inspection not enough improvement had been made and the provider was still in breach of regulation 17. We also found a new breach of regulation in relation to recruitment.
Why we inspected
The inspection was prompted in part due to concerns received about the leadership, the management of risks to people and quality assurance processes. We also undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.
We have found evidence that the provider needs to make improvements. Please see the full details of the report which is on the CQC website at www.cqc.org.uk
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 to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to recruitment and governance.
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.