Background to this inspection
Updated
20 January 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.
This inspection took place on 17 December 2020 and was announced.
Updated
20 January 2021
About the service
L and S Care Homes Limited - 3 York Terrace is a residential home providing personal care for up to three people. At the time of the inspection there were three people living at the service. People living at 3 York Terrace were younger adults with learning disabilities, who had lived at the home for several years.
3 York Terrace is a terraced house in a residential area and is split across three floors. Two bedrooms, a bathroom and an office were on the first floor whilst the ground floor had communal areas including a kitchen. There was a self-contained flat in the basement which opened out onto a small rear garden.
The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people that use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using the service and what we found
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service had not always supported best practice. People required one to one support and were not able to leave the home alone so when out were under constant supervision. If people cannot consent to constant supervision a Deprivation of Liberty Safeguard application may be required. The registered manager had not considered that people may need a Deprivation of Liberty Safeguard authorisation. New staff went through an induction period. People’s nutritional and hydration needs were met and people received support from health and social care professionals.
The registered manager told us that no staff training had taken place for the past 18 months. This was confirmed by staff. We were shown a supervision policy document that recorded that supervision meetings should take place every two months. No supervision meetings had taken place during the ten months prior to this inspection. Nevertheless, staff and professionals spoke well of the registered manager and people interacted with her in a positive way. Audit processes were in place. Feedback was sought from staff through handover meetings.
People were not able to tell us directly they felt safe however we observed staff interacting with people and we spoke to staff about their understanding of safety issues. Staff understood safeguarding and were aware of the whistleblowing policy. Maintenance checks were up to date and people received medicines safely. Risk assessments were individualised and up to date. Staff were recruited safely and there were enough staff working each shift to ensure people’s care and support needs were met.
Staff were caring and people’s privacy, dignity and independence were respected and promoted. People were encouraged to be involved in their care plan reviews and to contribute where possible. People’s differences under the Equalities Act 2000 were considered as part of care planning and respected.
People were supported in a person-centred way which focussed on peoples’ needs. Relatives told us they were involved in care planning and reviews. People had a programme of activities both inside and outside of the home which they were supported with. Routine was very important to people and this was understood by staff. Links to the local community had been established and a robust complaints policy was in place.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and the potential drivers for improvement.
As part of this thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The home did not use any restraint measures.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 30 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.