United Response - 9 Beverley Road North

Updated 3 November 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One Inspector, carried out the inspection

Service and service type

Beverley road north is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was not a registered manager in post. A new manager was in post and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced

What we did before inspection

We reviewed all the information we held on the service and sought feedback from other professionals. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make.

This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke one person who lived in the home and two relatives about their experience of the care provided. We observed how staff communicated with people in the home which was primarily through observations of people’s mood and simple questions and responses. Staff at the home knew people well so were able to use simple cues from people’s body language to ascertain responses to the information they needed from them around their preferences, consent and choices.

We spoke with three staff on the day of the inspection and received responses to questionnaires sent out from one staff member. We spoke with support staff, lead support workers, the manager and regional manager.

We reviewed a range of records. This included three people’s care records in detail and the daily records for five people. We reviewed three people’s medication records and three staff recruitment files. We looked at a variety of records relating to the management of the service, including policies and procedures, risk assessments and audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 3 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Beverley Road a residential care home providing personal care to five people at the time of the inspection. The service can support up to five people. The home is an extended Dorma bungalow, all bedrooms are on the ground floor as well as a kitchen and dining area and a lounge leading on to a paved patio and outside seating area. The upper floor holds a dedicated sleeping area for staff and office and storage space.

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

Right Support

Medicines management was not consistent with best practice and some staff’s knowledge in this area was a concern. Management took action to address immediate areas of risk.

Areas identified as concerning in fire safety practice and monitoring were not addressed in a timely way. Management were aware more action was required to address this area and we were told steps would be taken. Staff supported people to have the maximum possible choice, control and independence and control over their own lives. People were supported by staff to pursue their interests. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support.

Right Care

Staff promoted equality and diversity in their support for people. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity and they understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough staff to meet people’s needs and keep them safe and there was an ongoing recruitment and training programme to ensure staff were appropriately skilled. Staff, people supported, and their advocates cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staffing was becoming more stable led by an appointed manager who was registering with the commission. Management were working to ensure everyone in the home received consistent care from staff who knew them well. People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 (18 March 2018 )

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support Right care Right culture.

We received concerns in relation to risk management including safe care and the administration of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. During the inspection the provider took action to address concerns where required and plans were in place to address other issues already identified by the provider.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for United Response - 9 Beverley Road North on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to safe management of medicines and have made two recommendations to ensure oversight of risks to both the environment and the people supported is maintained at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.