Background to this inspection
Updated
18 October 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 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
Two inspectors carried out the inspection.
Service and service type
Burlington Villa is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Burlington Villa is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had about the service including notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law.
We sought feedback from the local authority and professionals who work with the service such as Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with three people who used the service and three relatives about their experience of the care provided.
We spoke with four members of staff including the registered manager and the deputy manager.
We reviewed a range of records. This included four people’s care records and five medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
18 October 2022
About the service
Burlington Villa accommodates nine people in one adapted building. The service provides support to people with a learning disability. At the time of our inspection there were nine people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The service was not always able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.
Right Support
Staff did not always support people to have the maximum possible choice and control over their own lives.
The service had locked all internal and external doors to manage the behaviour of one person but consequently it impacted on other people’s freedom. There was a wider concern relating to how the provider manages behaviours that challenge and whether the service supported a human rights approach.
Staff did not always support people with their medicines in a way that achieved the best possible outcome. The service did not maintain accurate and up-to-date records about people’s medicines.
When ‘as required’ (PRN) medicines were used to manage behaviour, records were not thorough or detailed. There was no evidence of post incident analysis or evidence of how well the medicines were effective in managing the behaviour.
People were supported by staff to pursue their interests and make plans for the future.
The service gave people care and support in a safe, clean and well-maintained environment. People had a choice about their living environment and were able to personalise their rooms.
Right Care
Some people were able to express their views and make choices.
People received kind and compassionate support. Staff were appropriately trained and had completed training in autism and equality and diversity.
People had access to healthcare professionals and were supported by staff to attend appointments.
Care plans were person-centred and demonstrated a good amount of knowledge about the people they supported.
Right Culture
Restrictions were put in place with no evidence of the least restrictive options being considered. There was limited opportunity for staff to learn from incidents and improve practice.
Audits were completed at the home to monitor the service and make any improvements needed although they did not always identify shortfalls we found at this inspection.
Staff turnover was very low, this gave people a more consistent approach from staff who knew them well. Some staff members had been in post for several years.
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.
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 the service under the previous provider was good, published on 1st November 2017.
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding. 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.
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 monitor the service.
We have identified breaches in relation to the safe care and treatment, safeguarding service users from abuse and improper treatment and good governance.
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.