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Hoffmann Foundation for Autism - 45a Langham Gardens Requires improvement

We are carrying out checks at Hoffmann Foundation for Autism - 45a Langham Gardens. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 September 2018

The inspection took place on 4 and 5 July 2018. We gave the provider notice of our intention to visit so that they could prepare people with complex needs whose routines might be disrupted by our inspection process.

Hoffmann Foundation for Autism - 45a Langham Gardens is a supported living service for people with a learning disability or autistic spectrum disorder. It provides personal care for people who live in their own accommodation. At the time of this inspection the service provided care for five people.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.'

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The inspection was prompted in part by concerns that had been raised with us by the local authority.

At this inspection we found that Hoffman Foundation did not provide clear leadership in setting the culture and values of the organisation. The provider informed us that they used Positive Behavioural Support (PBS) as a model to support people who displayed behaviours that challenged the service. However, staff demonstrated that they did not fully understand these values, and their role in achieving them. During this inspection, we observed practices and behaviours that were inconsistent with these values.

People living at the service were not protected and supported to be safe, as the provider did not have full oversight of the service. There was a lack of systems and processes in place to effectively monitor and improve the quality and safety of support provided. There were insufficient auditing systems in place to identify and mitigate any risks relating to the health and safety of people who lived at the service.

People were at risk of unsafe or inappropriate support because the risk assessments were incomplete. Furthermore, people were at risk of harm because not all risks had been identified with appropriate actions taken to mitigate risk. There were no effective systems for analysing accidents and incidents to help minimise the risk of events occurring again. The service did not always make sure staff deployed to support people had the necessary skills and experience.

Staff supported people to eat and drink. However, their food choices were not always taken into consideration.

Where people lacked capacity to make decisions about their care and support the service did not always follow legal requirements to assess their capacity and make decisions in their best interests.

A positive behaviour support (PBS) approach was used to supporting people who displayed or were at risk of displaying behaviours which challenged. However, the environment of the service was not consistent with PBS. People did not always receive individual care and support which met their needs according to their support plans and assessments. We found, although, communication systems had been considered, further improvement was required.

The service had processes in place to manage and administer people's medicines safely. The service was well maintained and kept clean. There were arrangements to protect people from the risk of the spread of infection.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to the back of the full version of the report after any representations have been concl

Inspection areas

Safe

Requires improvement

Updated 20 September 2018

The service was not safe.

People were at risk of harm because not all risks had been identified with appropriate actions taken to mitigate risk.

There were no effective systems for analysing accidents and incidents to learn from events to help minimise the risk of events occurring again.

The service did not always make sure staff deployed to support people had the necessary skills and experience.

Staff understood their responsibilities in relation to protecting people from harm and abuse. The service was clean and infection control protocols were followed.

The service used safe recruitment practices to ensure people were safe.

Medicines were managed and administered safely.

Effective

Requires improvement

Updated 20 September 2018

The service was not effective.

Staff were not suitably trained to meet all the care requirements of people living at the service. This was also true of agency staff.

When people lacked the mental capacity to make specific decisions by themselves, the principles of the MCA had not always been fully upheld.

Generally, people were supported to have food and drink. However, their food choices were not always taken into consideration.

People accessed health professionals such as psychiatrists and GPs when required.

Caring

Requires improvement

Updated 20 September 2018

The service was not caring.

We noted that the language that was used in the minutes of the meetings and care notes indicated a culture that was not of kindness.

Even though the feedback relating to staff was positive, the concerns we found at this inspection did not demonstrate a caring approach.

The service had a policy on ensuring equality and valuing diversity.

Responsive

Requires improvement

Updated 20 September 2018

The service was not responsive.

People did not always receive individual care and support which met their needs.

We found the environment to be requiring improvement to become more autism friendly.

Although communication systems had been considered, further improvements were required.

There was a system in place to manage complaints. People felt able to make a complaint and were confident they would be listened to and acted on.

Well-led

Requires improvement

Updated 20 September 2018

The service was not consistently well-led.

The service did not provide clear leadership in setting the culture and values of the organisation.

People living at the service were not protected and supported to be safe as the provider did not have full oversight of the service. There was a lack of systems and processes in place to effectively monitor and improve the quality and safety of support provided.

The service failed to implement effective systems for analysing incidents and accidents to learn from events and introduce changes to the support people received.