Archived: Sable Care Limited - 22 Ashbridge Road

Updated 30 December 2021

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 Care Act 2014.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Sable Care Limited - 22 Ashbridge Road 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

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 who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service. We also spoke with two members of staff which included the registered manager and one care staff member.

We reviewed a range of records. These included one person’s care records and one medicine record. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, policy and procedures, and quality assurance records. We spoke with one relative and two care staff members. Also, we spoke to a relative of a person who had recently left the service.

Updated 30 December 2021

About the service

Sable Care Limited - 22 Ashbridge Road is a residential care home providing personal care for up to four people with a learning disability and autism. At the time of the inspection one person was living at the home.

The home provides accommodation across two floors. People have their own bedrooms with shared bathrooms. The ground floor has a kitchen, dining room and living area.

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

Infection prevention control measures were not effective, and practices meant that people were at risk of infections. Staff did not use safe practices when using personal protective equipment (PPE). The provider had not deployed safe systems of care to manage people's medicines.

People were not supported by staff who understood best practice in relation to learning disability and/or autism. Complaints were not always dealt with effectively.

The service had an end of life policy however people’s end of life wishes were not explored. We have made a recommendation about exploring people’s end of life wishes.

People’s communication needs were not always met. Support plans were not accessible to people. We have made a recommendation about exploring communication needs for people.

There was a lack of oversight of the service and the provider had not developed a systematic approach to quality assurance to identify shortfalls and drive improvements.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of the five key questions the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The environment required modernising and was not homely. People’s care was not always person-centred and did not promote people’s dignity, privacy and human rights. Support plans were not accessible for people with learning disabilities. The service did not reflect best practice guidance for supporting people with a learning disability and/or autistic people. Staff did not have an understanding of autistic people when asked. The service did not provide specific training for people with autism. Ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using the service led confident, inclusive and empowered lives. The registered manager and staff referred to the home as ‘the setting’ and ‘the unit.’ They also referred to the person living at the home as ‘the client’ which meant the service was not person-centred.

People were not supported to have maximum choice and control of their lives and staff were not supporting people in the least restrictive way possible and in their best interests.

Discussions with the registered manager and staff showed they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

People were supported with food and nutrition intake. People had access to health and social care professionals.

The person who used the service and staff told us they liked the registered manager. Staff told us they felt well supported by the registered manager. The service worked with other organisations to improve people’s experiences.

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 1 November 2019).

Why we inspected

The inspection was prompted in part due to concerns received about support plans, people’s finances, medicines, accommodation and staffing raised by the local authority. We also had received complaints from members of the public. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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.

We reviewed the information we held about the service. Concerns were identified in the other key questions therefore the focused inspection became a comprehensive inspection looking at all five key questions.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the key questions of safe, effective, caring, responsive 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sable Care Limited - 22 Ashbridge Road on our website at www.cqc.org.uk.

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 safe and person-centred care; complaints; management; governance and in relation to their registration.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.