Background to this inspection
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 Act.
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
The inspection was carried out by one inspector.
Service and service type
United Response – 21 North View 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We reviewed information we had received about the service. 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. 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 with 3 relatives over the telephone in advance of the inspection. We spoke with 1 person, 1 relative and 3 staff, on site, including the registered manager and 2 support staff. We contacted 5 more staff and 4 external professionals via email. We spoke with the regional manager on the telephone.
We observed interactions between staff and people in communal areas. We reviewed a range of records. This included 2 people's care records and medication records. We looked at 2 staff files. We reviewed a variety of records relating to the management of the service, including policies and procedures, training records, meeting minutes.
Updated
3 November 2022
About the service
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 the Care Quality Commission (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.
United Response – 21 North View is a residential care home providing personal care and support to people, some of who may be living with learning disabilities and autism. The service can support up to 6 people.
People's experience of using this service and what we found
Right Support
¿ Staff supported people to follow their interests, such as swimming, music events, film nights and accessing the local community.
¿ People were supported to access specialist health and social care support by staff who knew them well and identified changes in their needs.
¿ Staff worked with a Positive Behaviour Support (PBS) specialist to help ensure there were positive strategies in place. PBS is a person-centred framework for providing support to people with a learning disability, and/or autism, including those with mental health conditions, who have, or may be at risk of developing, behaviours that challenge.
¿ Staff ensured people took their medicines safely.
Right Care
¿ Staff were well trained and received good ongoing support from the provider. There were sufficient staff to meet people’s needs safely. The registered manager did not have well established senior support in place. We have made a recommendation about this.
¿ Staff communicated with people well, using body language and demonstrating a knowledge of people’s non-verbal cues. The registered manager acknowledged they needed to improve the way people and families could engage with care planning and review. We have made a recommendation about this.
¿ Staff upheld people’s dignity by caring for them in a patient and skilled way.
¿ Staff had training on safeguarding and knew how to keep people safe. They worked well with other agencies to identify and reduce risks.
Right culture
¿ The ethos, values, attitudes and behaviours of the management and staff were in line with the key principles of guidance such as Right Support, Right Care, Right Culture. Staff felt well supported and there was a newly permanent core to the team. They understood their roles and responsibilities.
¿ Staff regularly reviewed and audited key information and documents. Lessons had been learned from previous incidents.
¿ People and those close to them had been involved in care planning but the provider needed to do more to ensure ongoing care reviews and engagement with people and relatives was accessible and inclusive.
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 12 August 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.