The Care Quality Commission
  • Care Home
  • Care home

1 Uppingham Gardens

Overall: Requires improvement read more about inspection ratings

Caversham, Reading, Berkshire, RG4 6SP (0118) 946 2216

Provided and run by:
Voyage 1 Limited

All Inspections

18 July 2022

During an inspection looking at part of 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 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

1 Uppingham Gardens is a residential care home providing personal care. It can support a maximum of seven people who are diagnosed with learning disabilities or associated needs. The home consists of seven bedrooms with two bathrooms. Communal dining, lounge, kitchen and large gardens enable people to spend quality time together in the two-storey detached property, located in a quiet cul-de-sac. At the time of the inspection seven people were supported at the service.

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

Right Support:

¿ The registered manager did not use safe recruitment procedures to employ staff. There was a risk people could be supported by unsuitable staff putting them at higher risk of harm.

¿ Staff supported people with their medicines in a way that promoted their independence. However, other aspects of medicine management such as record keeping, medicine stock checks and safe storage needed improvement.

¿ The service gave people care and support in a clean and well-furnished environment that met their sensory and physical needs. However, some aspect of premises safety such as maintenance checks, asbestos and water checks and action plan needed improvement.

¿ People had a choice about their living environment and were able to personalise their rooms. People invited us to view their rooms and showed us how they sorted their rooms.

¿ The service and staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.

¿ Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff communicated with people in ways that met their needs.

¿ Staff enabled people to access specialist health and social care support in the community.

¿ Staff supported people and relatives to play an active role in maintaining their own health and wellbeing.

Right Care:

¿ The registered manager did not ensure effective deployment of staff to meet people’s needs and keep them safe.

¿ The registered manager did no ensure safeguarding alerts were raised when needed. Not all staff were up-to-date training on how to recognise and report abuse.

¿ The registered manager did not ensure appropriate and consistent risk assessment, mitigation and review. Staff did not have current information on how they could help people cooperate to assess risks people might face.

¿ People’s care, treatment and support plans did not always reflect their range of needs and support so staff could promote their wellbeing and enjoyment of life.

¿ People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff spoke to people politely giving them time to respond and express their wishes.

Right Culture:

¿ We found the registered manager did not ensure we were notified of reportable events within a reasonable time frame.

¿ The registered manager did not follow their quality assurance policy effectively so they could assess, monitor and mitigate any risks relating to people, the service and others.

¿ The registered manager did not follow and accurately record and keep a copy of all the actions taken as required in the duty of candour regulation when a notifiable safety incident occurred.

¿ Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

¿ Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.

¿ Staff placed people’s wishes, needs and rights at the heart of everything they did.

¿ People and those important to them were involved in planning their care. Staff valued and acted upon people’s views.

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 22 April 2020) 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 two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous 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.

We carried out an unannounced comprehensive inspection of this service on 24 February 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance and notification of other incidents.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 1 Uppingham Gardens on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to quality assurance; risk management; notification of incidents; record keeping; management of medicine and premises; staff deployment and recruitment, and duty of candour at this inspection. We have made a recommendation about meeting Mental Capacity Act legal framework.

Please see the action we have told the provider to take at the end 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.

24 February 2020

During a routine inspection

About the service

1 Uppingham Gardens is a residential care home providing personal care. It can support a maximum of seven people who are diagnosed with learning disabilities or associated needs. At the time of the inspection six people were supported at the service. The home consists of seven bedrooms with two bathrooms. Communal dining, lounge, kitchen and large gardens enable people to spend quality time together in the two-storey detached property, located in a quiet cul-de-sac.

People’s experience of using this service

The registered manager did not have a thorough overview of the service. Although the provider had developed effective quality assurance and governance systems to enable improvement in the service. This meant we were not always notified of notifiable incidents.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff worked in partnership with external professionals to ensure the safe and effective delivery of people’s care. People, professionals and relatives reported people were safe living in the home. Staff had completed the provider’s mandatory training and understood their responsibility to safeguard people from discrimination, harm and abuse.

Risks to people were identified and effective measures implemented to ensure these were reduced and managed safely. People were supported by sufficient staff who knew them very well and were continually assessing their changing needs. The provider had a robust recruitment system in place, that ensured people were supported by staff who were safe to do so.

Medicines were managed safely and audits completed thoroughly to ensure people were supported in the safest way possible with medicines. People lived in a home which was clean and free from malodour.

People's needs were met by staff who had the necessary skills and knowledge to effectively carry out their duties. The provider operated an effective system of training, supervision and appraisal, which enabled staff to provide good quality care. It was acknowledged that competency assessments were not always evidenced, and this would need to be an area for further development.

Staff promoted people's health by supporting people to access health care services when required and by encouraging people to eat a healthy diet. Staff involved people and their relatives where appropriate, in decisions about their care, so that their human and legal rights were upheld.

Staff consistently treated people with kindness and compassion. People were supported to express their views and wishes about their needs, which were respected by staff. People's privacy and dignity were promoted by staff during the delivery of their care.

People experienced person-centred care which placed them at the heart of the service. Staff felt valued and respected by the registered manager and staff who had created a true sense of family within the service. Staff were passionate about people living in the home and continuously strove to achieve positive outcomes for them. People were supported to follow their interests and take part in activities that were socially and culturally relevant to them.

People and their relatives knew how to complain and were confident the registered manager and staff would listen and take appropriate action if they raised concerns. The provider had effective systems in place to respond and investigate complaints.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. 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.

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 30 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to Regulation 17 (good governance) and Regulation 18 (registrations) at this inspection.

Please see the action we have told the provider to take at the end 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

27 July 2017

During a routine inspection

This inspection took place on the 27 July 2017 and was unannounced.

1 Uppingham Gardens is a care home which is registered to provide care (without nursing) for up to seven people with a learning disability. At the time of the inspection there were six people living in the home. The home is a large detached building situated on a housing estate on the outskirts of Reading. It is located near to local amenities and public transport.

There was a registered manager for the service. 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 registered manager was also registered at another nearby home run by the provider organisation. She split her time between the two homes but was always available for advice and support.

The recruitment and selection process ensured people were supported by staff of good character. There was a sufficient amount of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

People were provided with effective care from a core of dedicated staff who had received support through supervision, staff meetings and training. People’s care plans detailed how they wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and/or health related issues. They helped to promote people’s independence whilst minimising the risks. Staff treated people with kindness and respect and had regular contact with people’s families, where possible and appropriate, to make sure they were fully informed about the care and support their relative received.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care.

Staff were supported to receive the training and development they needed to care for and support people’s individual needs. People received very good quality care. The provider had taken steps to periodically assess and monitor the quality of service that people received. This was undertaken by designated staff under the supervision of the home manager and the deputy manager. Quality was monitored through provider and internal audits, care reviews and requesting feedback from people and their representatives.

15 and 20 July 2015

During a routine inspection

The inspection took place on 15 and 20 July, and was unannounced.

 

1 Uppingham Gardens is a care home which offers accommodation for people who require nursing or personal care. Although registered to provide a facility for up to seven people, the location currently has six people using the service.    

The home is required to have a registered manager. The manager has been in post since November 2014, and has completed registration with the CQC. 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.

Staff knew how to keep people safe by reporting concerns promptly through a procedure that was displayed in the office. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met.  

We observed good caring practice by the staff. Relatives of people using the service said they were very happy with the support and care provided. People and where appropriate their relatives confirmed they were fully involved in the planning and review of their care. Care plans focussed on the individual and recorded their personal preferences well. They reflected people’s needs, and detailed risks that were specific to the person, with guidance on how to manage them effectively.

People told us communication with the service was good and they felt listened to. All relatives spoken with said they thought people were treated with respect, preserving their dignity at all times.

People were supported with their medicines by suitably trained, qualified and experienced staff. Medicines were managed safely and securely. We were unable to find the protocols for PRN medicines; this was raised with the registered manager, who assured us this would be written up immediately. PRN medicines are used on an as need basis. Staff were able to verbally describe the protocol, and the Medication Administration Record (MAR) sheets did not suggest disproportionate usage.

People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide legal protection for vulnerable people who are, or may become, deprived of their liberty.

People received care and support from staff who had the appropriate skills and knowledge to care for them. All staff received comprehensive induction, training and support from experienced members of staff. They felt supported by the registered manager and said they were listened to if they raised concerns.

The quality of the service was monitored regularly by the provider and the Operations Manager. A thorough quality assurance audit was completed quarterly with an action plan generated, and followed up during identified timescales. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service.

 

 

 

7, 9 May 2014

During a routine inspection

The inspection team who carried out this inspection consisted of one inspector. On the first day of the inspection they visited the home. On the second day of the inspection they contacted the relatives of people who use the service by telephone. The inspector gathered evidence against the outcomes we reviewed to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

The home had risk assessments for aspects of care that posed a risk to people who lived in the home. These assessments helped identify, address and minimise the risks to the individual.

We saw evidence to confirm that appropriate maintenance was being carried out on equipment, for example, portable appliance testing and fire safety systems.

There were effective recruitment and selection processes in place. Appropriate checks were undertaken before staff began work.

The provider had appropriate systems in place to effectively assess and monitor the quality of care they provided to people who use the service.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the home had liaised effectively with the local authority DoLS team.

Is the service effective?

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. People's needs were assessed and care was planned and delivered in line with their individual care plan.

The provider had appropriate policies and procedures in place to enable staff to ensure they obtained valid consent from people, where they were able. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

There was enough equipment to promote the independence and comfort of people who use the service.

Is the service caring?

During the inspection we observed care workers supporting people who use the service. Staff were respectful and caring. Care workers understood how people communicated and how people would express their likes and dislikes during the care planning process.

Is the service responsive?

We saw people's care records and risk assessments had been recently reviewed and updated. People who use the service, their relatives and health care professionals had been involved as appropriate. If any changes to people's needs were identified these were made.

Is the service well led?

People who use the service, their representatives and staff were asked for their views about their care and treatment. The provider had a robust quality audit system in place. We saw evidence that when issues had been identified, they were managed appropriately.

27 August 2013

During an inspection looking at part of the service

During our last visit, we identified concerns about people's care and welfare needs not being met. At this inspection we found the provider had taken appropriate action to ensure people who use the service experienced care, treatment and support that met their needs.

At our last inspection we identified continuing concerns about a lack of adequate maintenance of the premises in several areas, including paintwork, floorings and in communal bathrooms. At this inspection we found the provider had taken appropriate action to ensure that all the maintenance issues we identified had been addressed.

We previously identified concerns about people's personal records, because they were not accurate. At this inspection we looked at three people's care records. We found they had all been updated with the correct information about each person's care needs.

The provider was reporting applicable incidents as required by the regulations. This meant we could effectively monitor the quality and safety of care people who use the service received.

We spoke with the person managing the service on the day of our inspection. Throughout this report, we have referred to this person as the acting manager. The location did not have a registered manager at the time of our inspection.

14, 15 May 2013

During a routine inspection

People were supported in promoting their independence and community involvement. People were given the opportunity to take part in community activities. They were given the choice to participate and were able to decline if they wanted to.

Plans of care contained most of the relevant information to enable staff to appropriately care for people. The provider was not ensuring people were experiencing safe and appropriate care that met their needs. They did not carry out suitable assessments of people’s needs.

The provider had completed some maintenance of the premises. However, we found there were still areas where there was a lack of adequate maintenance and some maintenance work that had been undertaken was of a poor standard.

People who used the service, their representatives and staff were asked for their views about the care and treatment provided and these were mostly acted on. The provider had not reported applicable incidents to us which concerned the provision of care and welfare to people who use the service.

People’s personal records including medical records were not always accurate. People's care records had not been updated after a review of care.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register. They have since removed themselves from the register.

19 December 2012

During a routine inspection

We spoke with one person who uses the service and four of their relatives or representatives. They told us they or their relatives had been involved in the planning of their care. Care plans were person centred and tailored to meet the needs of the individual.

People who use the service had limited opportunities to undertake activities of their choosing in the community. Activities undertaken in the home included baking and aromatherapy.

People who use the service or their relatives told us people felt safe. Staff were able to demonstrate a good knowledge of recognising the signs of abuse and what action to take if they had any concerns. One relative told us they “could not fault their care”. Another said “they treat my relative well”.

The provider had not taken steps to provide care in an environment that was adequately maintained. We saw problems with flooring, stained sinks and cracked and peeling paint work.

Staff had regular training, but not supervision or appraisals. Staff told us they felt well supported by managers and the training they did receive enabled them to meet the needs of the people who use the service.

The provider had appropriate procedures in place to monitor the quality of the service they provide. They did an annual satisfaction survey and regular quality audits. They did not always take action when any concerns were highlighted for example maintainence of the property.