Archived: Searsons Way

About the service

Searsons Way is a residential care home which was providing personal care to 3 people at the time of our inspection. All people living at the service were autistic or had learning disabilities. The service can support up to 4 people in one adapted building over two floors.

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

Right Support

People were supported to live safely. Medicines were administered to people by staff who had been trained and competency assessed. This was an improvement from our last inspection. Evidence indicated people were supported by the right amount of staff. We made a recommendation about this at our previous inspection. Staff were recruited safely. People were supported through systems to safeguard them from abuse, this included financial abuse. We had made a recommendation about this previously. People were kept safe through good infection prevention and control practice. People were supported by other agencies which the provider assisted them to do.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care

Risks to people were assessed and monitored. The provider completed health and safety checks to ensure where people lived was safe. Care provided was person-centred and the provider aimed to meet people’s communication needs. The provider had quality assurance measures to monitor whether people got the right care.

Right culture

Improvements had been made at the service since our last inspection. However, relatives expressed concerns about whether there was open and positive culture at the service. Relatives told us they felt improvements could be made to how the service was managed, in particular how the service had work to do in becoming more transparent with their decision making and communications. Evidence showed the provider had recorded concerns and attempted to resolve issues and attempted to communicate with relatives. The provider had not re-registered the service along with its sister service next door, which was something they told us they would do at the last inspection.

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 (05 November 2020) and there were multiple 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.

At our last inspection we recommended that the provider follow best practice guidance on maintaining safe and suitable staffing levels, we recommended the provider follow best practice guidance on developing a culture of keeping people safe from abuse and we also recommended the provider follow best practice guidance on seeking advice and guidance from CQC about re-registering the service as it was not meeting the requirements of CQC ‘Right support, right care, right culture’ guidance for residential services for people living with learning disabilities and or autism . At this inspection we found improvements made around all three recommendations, but the service had not re-registered the service or sought guidance from CQC in this regard.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture and to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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

Searsons Way is a residential care home providing personal care to people with learning disabilities and/or autism.

The home is an adapted two floor building with facilities, including en-suite bathrooms. The home’s building design fitted into the residential area and 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.

The service was registered to provide support to up to four people and there were four people using the service at the time of our inspection.

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

The service was not always safe. Medicines were not managed safely because robust procedures were not in place to ensure staff administered medicines in a safe way. Protocols for staff were not in place for medicines that were given to people when needed.

People were not always protected from abuse because there were some serious incidents that occurred prior to our inspection, which put people at risk of harm. We have made a recommendation in this area.

We were not assured with the way staff were deployed in the home because some people required additional support, particularly when they went out. This could lead to shortages of staff and we have made a recommendation about this.

People’s care plans and risk assessments were not always up to date or reviewed when needed.

The provider had implemented a service improvement plan. However internal audits had not identified the concerns we found with medicine management.

The provider had failed to notify us within a suitable timeframe of when it had received authorisation to deprive people of their liberty.

Accidents and incidents that had taken place in the home were not always reviewed to learn lessons to prevent them re-occurring. The provider had a plan in place to improve this.

The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. However, the was situated next door to another home managed by the same provider. People were supported by staff who sometimes worked in the other home. Staff from the other home could easily access Searsons Way via the front door or garden. Both services operated as one larger service, for example by having a shared staff rota and food menu. This meant the provider had not mitigated against environmental factors which could make the environment feel institutional and had not ensured they could provide truly person-centred care.

We have made a recommendation about seeking advice and guidance about Registering the Right Support.

Premises and equipment safety was maintained to ensure the home environment was safe.

Staff had knowledge of people's needs, wishes and routines. They received training and support. The provider sought feedback from people to help make improvements to the service.

People and relatives told us staff were kind and caring but felt there could be better communication from the service. Staff had opportunities to discuss important topics and go through concerns they had with the management team.

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 good (published 20 February 2018).

Why we inspected

We received concerns in relation to people not being protected from the risk of abuse and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to medicines management, good governance of the service and registration regulations at this inspection.

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

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.

Searsons Way is a care home that accommodates four people in one adapted building. 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. On the day of our visit there were four people using the service. One person had gone away with their family and another was on respite care.

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.

On the day of our visit the registered manager took us around. 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.

People told us they felt safe. There were policies in place to safeguard people from harm. These were understood by staff who were able to demonstrate how they recognised and reported allegations of abuse. Risks to people were assessed and monitored in order to ensure that people were supported safely.

Incidents and accidents were managed safely. There were systems in place to ensure these were reported and analysed in order to reduce the risk of reoccurrence.

People were protected from the risk of infection because appropriate guidelines were followed by staff who had received the necessary training.

Recruitment processes remained robust and all the appropriate checks were completed before staff were employed. Sufficient numbers of skilled staff were deployed to ensure people's needs were met safely.

Medicines were managed safely and any anomalies or discrepancies were quickly rectified to ensure people received their medicines as prescribed.

Staff were supported by means of regular supervision, and annual appraisal. They had a comprehensive induction when they started and received on-going training to ensure they were able to support people effectively. Staff demonstrated an understanding of the Mental Capacity Act 2005 and how they applied it in their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The service continued to be caring and responsive to people’s needs. People told us they were treated with dignity and respect. Care plans were pictorial, individual and depicted people’s social, physical and emotional needs. A special effort and attention had been made to ensure information was accessible and in format people could understand.

People were supported to maintain a balanced diet that met their needs. They were enabled to access health care services when they needed in order to maintain their health.

Complaints were in a format that people could understand and were dealt with promptly.

People and staff continued to say the service was well led. We saw effective quality assurance systems in place.

The provider had policies in place to support the dietary needs of people who used the service. People had access to nutritious food based on their special needs and personal preferences. We found that staff were knowledgeable about ways to support people who used the service to remain healthy through dietary choices.

Support workers were responsible for the cleanliness of the service. We found the service to be clean, tidy and well maintained. The service had up to date infection control policies and training in place. Staff observed good hand hygiene practices and followed appropriate food handling processes to prevent risk of infection.

The provider used effective recruitment processes to select suitable candidates for vacant posts. Appropriate pre-employment checks were conducted to safeguard people who used the service.

Records held by the service about people, staff and management processes were up to date, accurate and stored securely.

The family members we spoke with made positive comments about the service and commented that communication between themselves and the provider was "excellent". People told us that they were able to participate in the care planning process and that comments and suggestions they made had been acted upon for example in terms of activities. Professionals we spoke with said that advice and recommendations they had made had been acted upon appropriately by the provider. Health and social care professionals also told us that the provider had contributed appropriately to multi agency meetings when held.