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Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 July 2018

The inspection took place on 12 and 13 June 2018 and was unannounced.

We previously inspected this service in March 2016 when the service was rated as good. The rating for the service from this inspection is requires improvement overall. This is the first time the service has been rated requires improvement.

The Goddards is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 14 people in one adapted building. At the time of this inspection the service supported 12 people with learning disabilities or an autistic spectrum disorder.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff did not always follow the provider’s medicine policy and procedure. This meant people were at risk from not having their medicines managed safely and administered as prescribed.

The provider failed to maintain records of checks completed on equipment that people used to assist them with their mobility and to keep them safe.

Systems and processes in place failed to ensure staff received training or refresher training to ensure their skills and knowledge remained up to date to carry out their role and meet people’s individual needs.

The provider told us on their PIR in February 2018 that they would implement spot checks , to check and record if staff were competent in their role or the activity of care they provided. However, we found this had not been put in place.

The provider completed a range of checks and audits to maintain and improve the service. However, the systems and processes were not robust and failed to highlight and action the concerns we found during this inspection. There was a lack of oversight to evaluate for example, any accidents and incidents that had occurred and to share outcomes with staff to improve experiences for people.

We observed there were enough staff on duty to meet people’s needs. People confirmed they received care and support from regular care workers who they knew.

People told us they felt safe living at the home and staff understood how to recognise and report any signs of abuse.

Staff had completed training on the Mental Capacity Act 2005 (MCA) and were able to discuss the importance of supporting people with their independence.

People received information in a format they could understand. Where people had communication difficulties, staff understood their needs and recognised their body language and expression. This ensured their ability to communicate was enhanced.

The provider included people or their representatives in annual discussions regarding their health and wellbeing. Any positive behaviour support plans were evaluated and included input by appropriate health professionals for effectiveness.

The provider had systems and process in place to ensure care workers were appropriately recruited into the service and had the necessary skills and personality to support individuals with their everyday needs and preferences.

Care plans included information to ensure staff were informed and respectful of people's cultural and spiritual needs.

People were supported to maintain a healthy and balanced diet. Care plans contained details of people's preferences and any specific dietary needs they had, for example, whether they were diabetic, had any allergies or religious needs.

Care workers had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

There was information available on how to express concerns and complaints. People were encouraged and supported to raise their concerns and processes were in place to ensure these were responded to.

People were supported to live fulfilled meaningful lives. The provider supported people to obtain skills to take up opportunities of work and attend college.

People discussed the activities and interests they could follow. People who chose to remain at the home participated in daily events. The provider supported people to maintain meaningful relationships and they were protected from social isolation.

We found the provider was in breach of three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3). You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 25 July 2018

The service was not always safe.

Systems and processes failed to ensure staff always followed the provider’s guidance to ensure people’s medicines were managed safely and administered as prescribed.

The provider failed to maintain information to record checks had been completed on equipment used to assist people with their mobility and to keep them safe.

Systems and processes helped to safeguard people from avoidable abuse.

Effective

Requires improvement

Updated 25 July 2018

The service was not always effective.

Systems and processes failed to ensure staff training was managed and to ensure staff had the appropriate skills and knowledge to carry out their role and meet people’s individual needs.

The provider followed legislation under the Mental Capacity Act 2005 and staff understood the importance of promoting people’s independence.

People received information in a way they could understand and were supported to maintain their health and wellbeing.

Caring

Good

Updated 25 July 2018

The service was caring

People's individual care and support needs were understood by staff and care plans included information to ensure care workers were informed and respectful of people's cultural and spiritual needs.

People's privacy and dignity was respected by staff who understood when to maintain confidentiality and when to share any concerns.

People told us they were treated with compassion, dignity and respect and they were involved in any decisions about their care and support.

Responsive

Good

Updated 25 July 2018

The service was responsive

People and their relatives were encouraged to be involved in planning their care and support.

Care plans recorded information about people's individual care needs and preferences.

There was a complaints procedure in place and people told us they knew who to speak with if they had a concern or complaint.

Well-led

Requires improvement

Updated 25 July 2018

The service was not always well-led

Audits and checks to maintain and improve the service failed to identify most of the concerns we raised. Where concerns had been identified actions had not been implemented in a timely manner.

The provider did not have effective systems and processes in place to continually evaluate and seek to improve their governance and auditing practice.

The provider completed consultations and used feedback to help shape the service.