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St Anne's Community Services - The Crescent Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 January 2020

About the service

St Anne's Community Services - The Crescent provides residential care for up to five people with a learning disability or autistic spectrum disorder. Five people were using the service when we inspected.

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.

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

People had been put at increased risk of harm because aspects of the service were not always safe. Recording issues meant we could not be sure people’s prescribed medicines were managed, stored and administered safely. Health and safety risks had not been identified and addressed in a timely way. For example, adequate window opening restrictors were not always in place. Records were not available to show equipment was checked, serviced and safe to use. Improvements were needed to reduce the risks associated with a fire occurring.

People did not benefit from an inviting and homely environment. Areas of the service were unclean. There were a number of maintenance issues throughout the service including damaged paintwork, fixtures and fittings. Cluttered communal areas made it harder to support people who used mobility aids.

Management and provider audits had been ineffective in identifying and addressing the concerns we found about the quality and safety of the service. The acting manager split their time between two of the provider’s locations and needed more support to address the concerns identified. Records were not always well maintained and statutory notifications had not been submitted as legally required.

The provider immediately responded to our concerns, arranging for the service to be deep cleaned, maintenance issues to be addressed and putting additional management support in place. Whilst this showed a positive commitment to improve the service, further sustained improvements were needed to make sure robust systems were in place to identify and address problems in future.

Although sufficient staff were deployed to meet people’s needs, there was a high level of agency staff used. New staff including agency workers had not always received a thorough induction to the service. There were some gaps in staff’s training. Staff received supervisions and an annual appraisal of their performance.

Staff were trained to identify and respond to safeguarding concerns. People’s needs were assessed and person-centred care plans and risk assessments were in place to support staff to safely meet people’s needs. Some risk assessments had not been reviewed in line with the provider’s own policies and procedures. Accidents and incidents were recorded and monitored to make sure appropriate action was taken to keep people safe.

People gave positive feedback about the food available. Staff supported people to make sure they ate and drank enough. We spoke with the acting manager about evaluating changes in people’s weight to help identify any issues or concerns.

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. Appropriate applications had been made when necessary to deprive people of their liberty.

People praised the kind and caring staff. The provider was working hard to recruit permanent staff and tried to use the same agency workers, so people were supported by staff who they were familiar with and who knew their needs.

Inspection areas

Safe

Requires improvement

Updated 25 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 25 January 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 25 January 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 25 January 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 25 January 2020

The service was not always well-led.

Details are in our well-led findings below.