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Mirabeau Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 18 March 2020

About the service

Mirabeau is a care home that provides care and support for up to ten people who have a learning disability or who are autistic and have complex support needs. At the time of our inspection there were ten people using the service, seven people lived in the main building and three people in a linked annexe called ‘The Garden Room.’

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service 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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Although the service was registered to accommodate more people than current best practice guidance, we found this did not have a negative impact on people’s quality of life. The size of the service was mitigated by the building design which included an annexe. The care home also blended well with other neighbouring residential properties.

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

Before our inspection we had concerns raised with us that there were not enough staff to meet people’s needs. When we inspected, we found the provider had started to address recruitment and retention, however they had not always ensured there were enough staff on duty to keep people safe.

There were detailed and personalised needs and risk assessments which provided excellent advice to staff, based on good practice guidance. Due to lack of adequate staffing, the care plans were not always followed as required.

The registered manager was committed and understood risk, however they had not had the resources to respond to the concerns with staffing levels. The provider was working with the local authority to address concerns; however, improvements were required to ensure open and clear communication about how the service decided on the numbers and skill levels of staffing . Staff recorded incidents and accidents. The provider was addressing how they monitored this information to ensure effective action was taken to keep people safe.

There had been improvements in the administration of medicine which demonstrated the service had learnt lessons when things went wrong. The provider ensured people were protected from the risk of infection and lived in well-maintained accommodation.

Staff were extremely motivated. There was a high-quality training programme which prepared staff well to meet people’s complex needs. However, some new staff had not yet attended key training, which left them unprepared for their role and lacking in confidence.

In response to recommendations at our last inspection, the service had introduced new measures to increase people’s independence and involvement in their care. Staff knew people well and communicated skilfully with people and promoted their views and choice. Feedback from families was positive about how caring staff were. Families and representatives were involved appropriately in people’s lives and decisions. They felt able to complain and be confident their concerns would be addressed.

Staff worked well with health and social care professionals to meet people’s needs. Meal times were personalised around people’s preferences and timetables. Staff provided the necessary support to meet nutrition and hydration needs.

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; the policies and systems in the service supported this practice. The registered manager agreed to review their applications to deprive people of their liberty to ensure they included all areas of possible restriction.

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Inspection areas

Safe

Requires improvement

Updated 18 March 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 18 March 2020

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 18 March 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 18 March 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 18 March 2020

The service was not always well-led.

Details are in our well-led findings below.