Archived: Care Management Group - 23 Pierrepoint Road

23 Pierrepoint Road is a residential care home providing care and support for up to 11 people who have a learning disability and may also have other health conditions, autism, mental health needs or physical disabilities. At the time of our inspection nine people were living at the service. The service was managed by the Care Management Group (CMG) Limited, a national organisation providing care and support to adults and children with disabilities in England and South Wales. The service is in the process of being registered under a new provider called Regard Achieve Together.

23 Pierrepoint Road is located in a residential area, similar in appearance to the other houses in the street.

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

During this inspection we were not always assured about the provider’s infection control practices. On the first day of our inspection, we found personal protective equipment (PPE) procedures were not always followed and there was poor signage around infection control. We also found cleaning was not completed to appropriate standards and audits were not effective. When we returned to complete the focused inspection, we found PPE, signs and audits had improved but some improvement was still required with the standard of cleaning.

We have made a recommendation to the provider about the monitoring of infection control practices.

The provider had systems in place to safeguard people from the risk of abuse. Medicines were managed safely. Safe recruitment procedures were in place and there were enough staff to meet people’s needs.

Care plans were personalised and recorded people’s preferences so staff knew how to respond to people’s needs effectively.

The provider had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people.

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 guidance CQC follows 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 by promoting choice and control, independence and inclusion.

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 13 November 2019).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about infection control. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with infection control. After going through our quality assurance checks, we widened the scope of the inspection on a second day to become a focused inspection which included the key questions of safe and well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service has not changed, but we have changed the rating of the safe key question from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Management Group- 23 Pierrepoint Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Care Management Group - 23 Pierrepoint Road is a residential care home providing care and support for up to 11 people who have a learning disability and may also have other health conditions, autism, mental health needs or physical disabilities. At the time of our inspection nine people were living at the service.

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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 11 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

The provider had systems to help protect people from the risk of abuse. Staff had appropriate training and knew how to respond to possible safeguarding concerns. Safe recruitment procedures were followed and there were enough staff to meet people’s needs. Medicines were safely managed, and staff used appropriate infection control practices to prevent cross infection.

Supervisions, appraisals, and training provided staff with the support they required to undertake their job effectively and safely. People's needs were assessed and reviewed as required. People were supported to maintain their health and access healthcare services appropriately. People were also 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.

People and their relatives told us they were satisfied with the care people received and that staff were kind and caring. People were supported to make day to day decisions and have choices.

People were engaged in activities both within and outside the home that were specific to their interests. Relatives were welcomed to the service. The provider had a complaints procedure and responded appropriately. At the time of the inspection no one was receiving end of life care but the provider recorded information on people’s end of life wishes.

The provider had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people. The registered manager was approachable and promoted an open work environment.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. We found this service did not use restrictive intervention practices.

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 19 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Care Management Group - 23 Pierrepoint Road is a care home for up to 11 adults who have a learning disability and may also have other health conditions, autism, mental health needs or physical disabilities. The service is managed by Care Management Group (CMG) Limited, a national organisation providing care and support to adults and children with disabilities in England and South Wales. They manage over 120 services, including other residential care homes, day centres and supported living services. At the time of our inspection nine people were living at 23 Pierrepoint Road. The people living there had a range of different mental health, learning and physical disability needs. There was a registered manager in post who had worked at the service for many years.

At the last inspection on 14 July 2015 we rated the service Good.

At this inspection on the 27 June 2017 we found the service Good.

People living at the service and their relatives were happy with the care they received. They felt at home and were able to make choices about their lives and how they spent their time. The staff treated people with kindness and respect and there was a friendly and caring atmosphere at the service. People's needs were assessed, planned for and met by the staff working with other health care professionals. People took part in a range of different activities which met their needs and reflected their preferences.

There were procedures designed to keep people safe. These included assessing individual risks and planning how to minimise the likelihood of harm for people. People received their medicines in a safe way and as prescribed. The staff understood about abuse and how to report any concerns they had. They also knew how to report and respond to inquiries and incidents.

There were enough staff to keep people safe and meet their needs. The staff team worked well together and supported one another. Communication within the staff team was good and they planned how to meet people's needs each day. The staff felt supported and told us they could speak with the registered manager about any concerns they had. They took part in regular team and individual meetings and an annual appraisal of their work. There were good opportunities for the staff to learn new skills and take part in training which helped them to understand their roles and responsibilities.

The service was well-led by an experienced manager who worked alongside the staff team to support people who used the service. There were good systems for auditing the quality of the service. Records were appropriately maintained, clear and up to date. The registered manager told us that the provider was supportive and they had the guidance and information they needed.

At this inspection we found that improvements had been made to ensure that people were protected from the risks of unsafe or inappropriate care, where each person's care had been reviewed and new support plans and risk management plans were in place to enable staff to support people with their needs.

People were involved in identifying their preferences and wants. This was reflected in the individualised support plans that detailed how people liked to live their life and how they were supported with this.

People received support with their medicines and these were stored appropriately within the home.

Staff received support and training in their work and the staff we spoke with said there was good team work to ensure people received a consistent level of support.

However, we found that the records relating to the care and support that people received were not kept up-to-date and some were not reviewed regularly. This did not ensure that people received the most relevant care for their needs.