L'Arche Bognor Regis Bethany

Updated 30 June 2023

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 Health and Social Care Act 2008.

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 undertaken by 1 inspector.

Service and service type

L’Arche Bethany is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. L’Arche Bethany is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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 a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day. We announced the inspection on day 2.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed documentation, inspected the safety of the premises and carried out observations in

communal areas. We spoke with 4 people who used the service and 6 members of staff including the

registered manager and care policy and quality manager.

We reviewed the care and medicine records for 5 people. We looked at a range of records. This included information about staffing, policies and procedures, environmental safety and information relating to the governance of the service.

Updated 30 June 2023

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

L’Arche Bethany is a residential care home providing personal care to 6 people at the time of the inspection. The service can support up to 6 people.

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

Right Culture: The provider did not always support the delivery of high-quality, person-centred care. Quality assurance systems and processes to maintain and develop the safety and quality of care were not always operating effectively. The provider had not done all of the things we had asked them to after the last inspection. People told us they liked the staff and liked the support they received. They enjoyed living at Bethany and their equality and diversity was respected.

Right Support: Staff supported people to take part in some activities and interests in their local area. People told us they were not doing some of the things they would like to do. This is an area that needs to improve. Staff supported people with their medicines in a way they wanted but we found some medicines were not managed well. People lived in shared accommodation. They had their own bedrooms which they were able to personalise. Staff carried out daily living tasks, such as cooking and cleaning, whilst actively supporting people to take part.

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.

Right Care: People did not always receive the right support to keep them safe or well. People told us they received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 1 September 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

We undertook this inspection to follow up on action we told the provider to take at a previous inspection.

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.

We undertook an unannounced comprehensive inspection of the service on 26 and 27 May 2022. There were multiple breaches of legal requirements. Warning Notices were served in relation to the following regulations of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014;

Regulation 9 (Person-centred care) Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 17 (Good governance). The provider was required to be compliant with these regulations by 5 September 2022.

We undertook this comprehensive inspection to check whether the Warning Notice we previously served in relation to Regulations 9, 12, 13 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

We have found the provider had not met the requirements of the Warning Notice for Regulations 9, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Please see the safe, effective and well-led sections of this report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for L’Arche Bognor Regis Bethany on our website at www.cqc.org.uk.

Enforcement

We have identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment, person centred care and good governance.

In response to the serious concerns found during inspection we have imposed conditions on the providers registration for L'Arche Bethany.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.