Durham Street

Updated 16 February 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by two inspectors.

Service and service type

Durham Street and Endymion Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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. We sought feedback from the local authority and professionals 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. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service about their experience of the care provided. We spoke with three members of staff including the registered manager and care workers.

We reviewed a range of records. This included three people's care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with one relative about their experience of care provided.

Updated 16 February 2022

About the service

Durham Street and Endymion Street is a residential care home that provides accommodation and personal care to young people who have a learning disability, autistic spectrum disorder, physical disability or sensory impairment. The service can support up to seven people. At the time of our inspection visit there were three people living at the service.

49 - 53 Durham Street is registered to provide care and accommodation for up to five adults with a learning disability. 48 Endymion Street is a terraced property which is registered to provide care and accommodation for two adults who have a learning disability. They are both part of the Avocet Trust organisation, which is a registered charity.

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

The service was not always well-led. The provider's quality assurance systems were not effective in identifying and addressing issues.

Risks associated with people's care had not always been clearly recorded in their care plan or risk assessments, and there was a lack of detail about the measures in place to reduce the risk of harm.

People's care plans did not always contain sufficient information to ensure staff were fully aware of people’s needs.

The principles of the Mental Capacity Act (MCA) 2005 were not always followed. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff were recruited safely. There were enough staff to meet people's care needs. Staff had received training for their roles.

The home was clean and tidy and additional cleaning ensured people were safe from the risk of infection.

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

The model of care and setting maximised people's choice, control and independence. People's dignity, privacy and human rights were promoted, but improvements were required to MCA practices to ensure that people’s human rights were always fully promoted. The ethos, values, attitudes and behaviours of care staff ensured people using the service led confident and inclusive lives.

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 11 October 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and risk management associated with incidents and accidents. A decision was made for us to inspect and examine those risks.

Due to the concerns received, we undertook a focused inspection to review the key questions of Safe and Well-led'. When we arrived, we also had concerns about areas covered by the 'effective' domain. We decided to include this 'effective' domain in our inspection. 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.

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 have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Durham Street and Endymion Street 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 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This included a breach of regulation 12 (safe care and treatment), regulation 11 (consent) and regulation 17 (good governance).

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 from 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.