Sewells

About the service

Sewells is a residential care home providing personal care to 3 people at the time of the inspection. The service can support up to 7 people.

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

Right Support:

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 access specialist health and social care support in the community. People were supported safely with medicines. The staff team was appropriately trained to meet people’s needs.

People were safeguarded from abuse and staff were knowledgeable about how to support people safely. Accidents and incidents were recorded and shared with staff to promote learning.

People were supported to pursue their long-term aspirations and we observed meaningful interaction with people.

Staff had the skills and training to recognise and support a person when they were feeling overwhelmed or distressed.

Right Care:

People were supported by caring and kind staff. Staff knew people very well and knew their likes and dislikes. Positive relationships were noted between staff and people. People said staff were kind to them and we observed staff interact with people kindly,

The provider and manager had worked to change the culture at the home to one of empowerment for people where staff truly promoted people’s individuality, protected their rights and enabled them to develop and flourish.

Staff had received some sector specific training to enable them to meet the needs of people and to keep them safe from the risk of harm.

People’s care and support plans reflected their range of support needs.

Right Culture:

Staff placed people’s wishes, needs and rights at the heart of everything they did. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

People had assessments in place to identify risks they faced and to guide staff to manage these. Staff were knowledgeable about the content of these risk assessments and the actions they needed to take.

People were supported by staff who had received training and competency assessments to meet their support needs. People were supported by staff who understood best practice in relation to supporting people with a learning disability.

Relatives, people and staff spoke highly of the manager and said how the culture has changed in response to the support and guidance they have provided.

The providers quality assurance system helped to ensure people lived in a service with the right culture and approach to help them live their lives without discrimination or judgement.

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 the service was Inadequate published on 27 October 2022 and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 27 October 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced inspection of this service on 30 August 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 safe care and treatment, staff training and support, personalised care and governance systems.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. 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 changed from Inadequate to Good. 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 Sewells on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Sewells is a residential care home providing personal care to five at the time of the inspection. The service can support up to seven people.

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

Right Support

People were not supported to pursue their long-term aspirations and we found limited meaningful interaction with people.

Staff did not have the skills or training to recognise and support a person when they are feeling overwhelmed or distressed.

People were not always supported in a way that maintained their own health and wellbeing.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice

The service was focusing on improvements to the environment people lived in to ensure it was clean, well maintained and appropriate equipment was in place. Although not everyone was able to have access to the whole home. People were able to personalise their rooms.

People received their medicines when they needed them, and staff were mindful when people needed medicines.

Right Care

People were not always supported by a service that had effective systems in place to report and respond to accidents and incidents. Staff did not always understand how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse, however staff actions did not always show they understood this.

People said staff were kind to them and we observed on the whole staff interacted with people in a kind way, however we found further improvements needing to be made to instil a culture of care in which staff truly promoted people’s individuality, protected their rights and enabled them to develop and flourish. There were long periods of time where people did not have any interactions with staff, and we found some staff using language and expressions that were not always respectful.

Staff were not appropriately trained to meet the needs of people to keep them safe which resulted in people being put at risk of harm.

People’s care and support plans did not reflect their range of support needs. Staff either did not know where to find the information or gave inconsistent information in how to support the people.

Right Culture

People did not always have assessments in place, to identify risks people faced and how staff should manage these. Staff were not always knowledgeable about the content of these risk assessments. When risks to people were identified actions to mitigate these were not resolved in a timely manner which put people at risk of harm.

People were supported by staff who were not adequately trained to meet their support needs. People were not supported by staff who understood best practice in relation to supporting people with a learning disability.

The service had a recent change in management. Staff acknowledged this had helped improve the service and the support they received. Relatives and people spoke highly of the new manager in post.

People’s quality of support was not always enhanced by the providers quality assurance system the provider had in place. Actions were not always documented, and it was unclear if actions were completed. This had an impact on people’s care.

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 the service under the previous provider was requires improvement, published on 23 April 2021 and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We carried out an unannounced focused inspection of this service on 24 February 2021 under the previous provider. 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 safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. 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 changed from requires improvement to inadequate. 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 Sewells on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 identified breaches in relation to people safety, staff training and the lack of quality assurance systems in place at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.