Monaveen

Updated 8 December 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 27 June 2023 and ended on 4 July 2023. We visited the location’s service on 27 and 28 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. 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 used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 6 relatives about their experience of the care provided. We spoke with 9 members of staff including the registered manager, 2 assistant care managers and 6 care support staff. We reviewed the care and medicine records for 6 people. We looked at a range of records. This included information about staffing, policies and procedures and information relating to the governance of the service.

After the inspection

The provider sent us information we requested including about staff training, and an action plan showing immediate actions they had taken following feedback from this inspection.

Updated 8 December 2023

About the service

Monaveen is an extra care scheme. Staff provided personal care to people living in their own apartments within one large purpose-built building. The service provided support to people with a range of care support needs including physical disabilities, people living with dementia, Parkinson’s disease, Huntington’s Chorea and learning disabilities. At the time of our inspection there were 33 people using the service.

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

Right Support: Systems for managing medicines were not always consistent and some risks to people had not been assessed. People said they felt safe living at Monaveen. Staff understood their responsibilities for safeguarding people from abuse. 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.

Right Care: People were not always receiving a personalised service because there remained a high dependency on agency staff who were not all familiar with people’s individual needs and preferences. The quality of assessments and care plans had improved since the last inspection but not all staff were referring to these documents when providing care to people. This meant people were at risk of not receiving consistent care and support in line with their care plan. One person told us, “There’s no continuity (of staff), what’s in the care plan doesn’t happen.”

Right Culture: Difficulties in recruiting and retraining staff had continued and this had a negative impact on people’s experience of the service. One relative told us, “They often ring me to say there has been a stranger in to do their care.” People, relatives and staff described poor communication and a lack of engagement with the service. A failure to embed quality assurance systems meant improvements seen at the last inspection had not been sustained.

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 26 January 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections. 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 the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to the management of medicines, staffing and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. 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 based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective 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. Following the inspection the provider sent an updated improvements plan showing the immediate actions they had taken following the inspection to mitigate risks we identified.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Monaveen on our website at www.cqc.org.uk.

Follow up

We will request an action plan for 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.