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Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 November 2018

We inspected this service in December 2015 and rated the home as ‘Good’ overall. At this inspection, on 20 September 2018, we rated the service as ‘Requires Improvement’ overall. This is the first time Hubbard Close has been rated as Requires Improvement. This inspection was announced the day before we visited. This was to ensure a member of staff would be present to let us into the home.

Hubbard Close 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.

Hubbard Close provides personal care and accommodation for people who have a range of learning disabilities. Hubbard Close can provide care for up to five adults. At the time of this inspection five people were living at the home. Hubbard Close comprises of accommodation over two floors.

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.” Registering the Right Support CQC policy.

There was a registered manager in place when we inspected the home. 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’s risk assessments and the care plans created to guide staff about how to manage and respond to certain risks, had not been updated or were not completed fully. A plan to manage a person’s safety in the community was not robust.

The service was not compliant with the Mental Capacity Act 2005. An activity a person engaged with was being controlled by staff. The persons’ ability to agree to this restrictive plan had not been checked. They had not been involved in this plan. The plan was not being reviewed on a regular basis. There were gaps in the recording of some people’s capacity assessments. It was not always clear that these assessments were robust. Even though, these assessments were considering if people could make certain important decisions about their lives.

The provider and registered manager’s audits were not always effective or thorough. At times, these audits did not always consider if people’s experiences could be improved upon or lead to action to try and make this happen. People were funding elements of their care rather than the provider looking at alternatives to this.

These issues constituted breaches in the legal requirements of the law. There were three breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of the report.

There were various safety checks taking place to ensure people received safe care and support. However, there were some shortfalls in this area. These related to timely action to issues identified about the building, infrequent fire evacuation drills, and gaps in people’s risk and care assessments. Lessons were not always being learnt or considered when incidents took place affecting the people at the home.

Staff recruitment checks were not complete or well evidenced. We made a recommendation that the service improved this aspect of people’s safety.

People received support to access health care services when they needed this input. Staff also followed up concerns and outstanding issues in relation to people’s health needs.

The service was involving people with what foods were available to them and they were promoting healthy options. People

Inspection areas

Safe

Requires improvement

Updated 20 November 2018

The service was not always safe.

People’s risk assessments were not up to date and they did not always give clear guidance to staff about managing these risks.

A plan to manage a person’s safety when they were out was not robust.

Safe recruitment checks on staff were not complete.

Incidents were not analysed to see what lessons could be learnt or to see if elements of people’s care planning could be improved upon.

Some elements of fire preventions were not completed.

Effective

Requires improvement

Updated 20 November 2018

The service was not always effective.

People’s capacity to make certain decisions was not always assessed and reviewed effectively.

Staff maintained control over a person’s daily activity. This had not been appropriately assessed and the person had not been involved in an open and meaningful way with this restrictive plan.

People had access to health care services when they needed to.

People enjoyed the food and healthy options were promoted at the home.

Caring

Good

Updated 20 November 2018

The service was caring.

Staff were kind and thoughtful towards the people who lived at the home.

Staff treated people with respect.

People’s confidential information had not always been stored securely.

Responsive

Requires improvement

Updated 20 November 2018

The service was not always responsive to people’s needs.

People had end of life plans in place, but these were not person centred.

People’s rooms were not always valued as their spaces.

People interests and likes were identified.

Activities and events were planned to meet people’s interests.

People were asked about their views of the care they received.

There was a complaints process at the home which people used.

Well-led

Requires improvement

Updated 20 November 2018

The service was not always well led.

The provider and registered managers audits were not effective or robust.

Action was not taken in a timely way or considered when issues arose about the building.

There was a positive culture at the service.