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Merle Boddy House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 November 2019

About the service

Merle Boddy House is a residential care home providing personal and nursing care to people with learning disabilities or autistic spectrum disorder. The service can support up to ten people. At the time of our inspection there were eight people using the service.

The service had not been developed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who 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 did not receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were not always supported to have maximum choice and control of their lives.

Risk assessments were not robust enough to ensure people were kept safe. Not all risks had been identified to ensure people were supported appropriately. Staff did not always keep up to date with changes to people’s risk assessments.

Staffing levels were not managed to ensure that staff could support people to access the community on an individual basis. People were not always supported to develop their interests and take part in their preferred activities. People were not being supported to develop in areas that were important to them.

People were not always supported with maintaining a healthy diet. People were not always involved with their care and support.

Staff received training, however, training in relation to supporting people with learning disabilities could be improved. We have made a recommendation in the report.

The service was not well-led and lacked leadership. Staff did not feel supported. Quality assurance systems did not identify issues which could pose a risk to people’s health and safety. Audits had failed to identify issues. Not all actions from the previous CQC inspection were completed to ensure the required improvements were made and lessons were learnt. Files were not always updated to be kept in line with best practice and to reflect people’s personal care needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

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 who 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 of the potential drivers of improvement.

As part of 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. No restrictive intervention practices were used.

Rating at last inspection and update

The last rating for this service was Requires Improvement

Inspection areas

Safe

Requires improvement

Updated 20 November 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 20 November 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 20 November 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 20 November 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 20 November 2019

The service was not always well-led.

Details are in our well-led findings below.