10 November 2020
During an inspection looking at part of the service
Life Opportunities Trust - 15 Rose Vale is a care home providing accommodation for up to eight people with a learning disability or autism, including older people, some of whom are living with dementia and or a physical disability. At the time of the inspection there were six people living at the home.
People’s experience of using this service and what we found
Since the last inspection, there have been two different managers in post. The current registered manager is on a leave of absence, so the home was being managed by a third and interim manager.
Training relating to infection control and COVID-19 had been delivered. However, staff did not feel confident in their knowledge. In addition, we saw staff were wearing long sleeves which did not allow for the ‘bare below the elbow’ rule for effective handwashing. We also found that staff removed their masks to eat and drink with people. This had not been risk assessed or determined as to if it was necessary, even though staff members had tested positive for COVID-19.
Staff training, supervision and support had been lacking at the last inspection. Staff told us this had started to improve with the interim manager in post. Staff hoped they would stay at the service.
The environment had not improved. The refurbishment plan had not been completed due to delays caused with the pandemic. The interim manager and the provider were aware of the improvements that were required and were focused on making those improvements.
The recruitment process was managed by head office and as a result there was limited information held in the home about new staff starting. We found that the management of the recruitment process for staff needed to be more robust.
Governance systems needed to monitor and identify concerns had been developed however it was too early to tell if these had been effective as due to the pandemic and the number of changes to the manager of the home. Audits for areas such as infection control, care plans and medicines were completed. However, the medicines audit needed further development to ensure it identified shortfalls such as recording gaps.
People told us they felt safe and that staff were kind, they liked them and liked living at the service.
Incident, events and unexplained injuries were recorded and investigated. Where needed, incidents were reported appropriately.
We were told that things at Life Opportunities Trust - 15 Rose Vale had improved with the interim manager in post. They were working to implement training, systems and guidance to help address previous 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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
People spent their day in a way they chose, for example, one person wanted to stay in bed a bit later so staff didn’t disturb them. People told us they could make their own choices about eating and daily routines, people were able to get out to the places they enjoyed prior to the recent lockdown and relationships were supported. Staff had developed relationships with people, and we saw people were treated as equals.
Rating at last inspection
The last rating for this service was requires improvement (published 12 February 2020) and there were multiple breaches of regulation. The provider sent us an action plan stating how they would make the required improvements.
Why we inspected
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We undertook a targeted inspection to follow up on the concerns we had at the last inspection and specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the care people were receiving. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns.
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 coronavirus and other infection outbreaks effectively.
Please see the safe section of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Life Opportunities Trust - 15 Rose Vale on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.