Background to this inspection
Updated
21 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 conducted by 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Support for Living Limited - 246 Haymill Close 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. Support for Living Limited - 246 Haymill Close 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.
What we did before 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
During our visit we spoke with a person who used the service, 3 support workers, the chef, the deputy manager, the registered manager and 2 area managers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed a range of records relating to the management of the service including medicines support records, health and safety records, and quality checks of the service. We also spoke with 6 relatives of people who use the service and 3 professionals who had worked with the service recently. We continued to seek clarification from the provider to validate evidence found. We looked at procedures, staff training and recruitment records, medicines support checks, and 3 people’s care plans and records.
Updated
21 June 2023
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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
About the service
Support for Living Limited - 246 Haymill Close is a care home for up to 7 people with learning disabilities and/or autism. At the time of our inspection, 7 people were living at the service.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. However, they needed to make improvements to fully meet these.
Right Care
People received kind and compassionate care and staff respected their privacy, but their dignity was not respected at all times.
Staff understood and responded to their individual needs. They communicated with people in ways that met their needs.
The service had enough staff to keep people safe. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff attended training and completed an induction to help them support people.
Right Culture
The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support.
There was a service culture of supporting people to receive compassionate care that was tailored to their needs, but we received mixed feedback about the leadership at the home.
The service involved people and those important to them, including advocates, in planning and reviewing their care.
Right Support
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; however the policies and systems in the service did not support always this practice.
Staff supported people with their medicines safely, but the medicines management arrangements were not always effective.
Staff enabled people to access health and social care support in the community.
People had some choice about their living environment and were able to personalise their rooms. Staff supported people in a clean and equipped environment and the provider had processes in place to maintain this.
The provider follow appropriate recruitment procedures to ensure only suitable staff were recruited to work at the service.
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 1 July 2022).
Why we inspected
We received concerns in relation to providing safe support to people. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only. We inspected and found there were concerns with promoting people’s dignity and working in line with the Mental Capacity Act 2005, so we widened the scope of the inspection to become a focused inspection which included the key questions of Caring and Effective as well. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring and Well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Support for Living Limited - 246 Haymill Close on our website at www.cqc.org.uk.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to treating people with dignity and respect, safe care, record-keeping and governance at this inspection. Please see the action we have told the provider to take at the end of the full version 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 continue to monitor information we receive about the service, which will help inform when we next inspect.