Background to this inspection
Updated
2 November 2019
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
Two Inspectors, an Assistant Inspector and a Specialist Advisor [with a specialism in learning disabilities], conducted the inspection.
Service and Service Type
Clacton Family Trust 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 registration also includes supported living. This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
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 and professionals who work with the service. We used the information the provider sent us in the Provider Information Return (information Providers are required to submit which details key information about their service, their view of what they do well, and improvements they plan to make). This information helps support our inspections. We used all this information to assist in the planning of our inspection.
During the Inspection
The majority of people we met during Inspection had complex needs and were not able to tell us of their experiences of life at the service. We therefore used our observations of care and our discussion with relatives, professionals and staff to help form our judgements.
We spoke with four relatives about their experience of the care provided. We spoke with eleven members of staff including the registered manager, manager, team leaders and support workers.
We reviewed a range of records. This included three people’s care records and multiple 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.
After the Inspection
We continued to seek clarification from the provider to validate evidence found and request any additional information. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.
Updated
2 November 2019
About the service
Clacton Family Trust provides accommodation and care for people with a learning disability and physical disabilities within a care home and supported living flats. The care home consists of five bungalows on one
site. At the time of our inspection there were 37 people using this part of the service. Clacton Family Trust so provides personal care to people living in supported living units. People who use this part of the service have their own tenancies and receive most of their support from staff employed by Clacton Family Trust. At the time of our inspection, there were 33 people living in supported living units. These were predominantly located in a purpose-built property within the local area.
The care home has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This should ensure that people who live in the care home can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People living in the care home did not always receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People's medicines were not always managed safely
The service did not learn and make changes where improvements were identified by professionals to ensure people were safe.
The provider did not always maintain the environment to ensure it was safe for people living in the service. We recommend the provider a maintenance schedule is implemented to address environmental improvements.
The service was not consistently well led. The provider and management lacked effective oversight of the service in order to take prompt action when things started to go wrong
Systems were in place to monitor the quality of the service; however, these were not effective and failed to highlight concerns raised during the inspection.
The service did not learn and make changes where improvements were identified by professionals to ensure people were safe
End of life care plans were not always in place for people. We recommend the provider develops end of life care planning for people.
People’s dignity was not always maintained did staff interacted with people in a caring and compassionate way.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.
Mental capacity assessments were not always person centred and decision specific. We have recommended mental capacity assessments are reviewed.
People had access to adequate and meaningful activities for people
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 4 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.