Archived: Royal Mencap Society - 97b Barnby Gate

Royal Mencap Society - 97b Barnby Gate is a residential care home providing accommodation and personal care for five people who have learning disabilities. The service can support up to 6 people. The property is a single storey bungalow with a small private garden.

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

The provider's quality monitoring and governance processes were somewhat effective. The impact of this was seen in the way some audit failures and care planning issues had not been identified by the provider until we inspected.

The manager supported people to achieve good care outcomes and understood their responsibility to notify relevant authorities when incidents occurred. The service had a positive relationship with specialist health care agencies who were involved in supporting people at the care home

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 his practice.

People had person centred care plans. People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. People were supported and provided with sufficient food and drink to meet their dietary needs.

People were protected from catching and spreading infections because risks were assessed and managed appropriately. Safeguarding systems and processes were in place. People received their medicines as prescribed for them. People were supported by a sufficient number of staff to meet their needs. Staff were recruited safely.

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The size of service met current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life.

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 23 July 2020) and there were multiple breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 22 May 2019. 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.

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, Effective and Well-led which contain those requirements.

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 ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 Royal Mencap Society – 97b Barnby Gate 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.

People’s experience of using this service: Timely action had not been taken to ensure the premises and equipment were safe and well maintained. The décor of the home did not fully meet people’s needs. The registered manager and staff had already identified areas which needed refurbishment and redecoration. This included the lounge, bathrooms, corridors, several people’s bedrooms and the garden area.

Following our inspection, the registered manager took immediate action to address the shortfalls. She sent us photographs of the decoration and refurbishment which had taken place.

Whilst we were satisfied that action had been taken to improve. We considered that an effective system was not in place to ensure that equipment and the premises were well maintained and make sure timely action was taken when shortfalls were identified.

The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The size of service met current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life.

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.

Most people were unable to communicate verbally . We saw that people were relaxed around staff and appeared happy. There were no ongoing safeguarding concerns.

People were supported by staff who were suitably trained and supported. People’s nutritional and hydration needs were met and staff supported people to access healthcare services and receive ongoing health and social care support.

There was a cheerful atmosphere at the home. Staff were knowledgeable about people’s needs and what made people happy. People’s independence was promoted. People helped to shop, prepare and make meals.. Housekeeping skills were also promoted.

People were supported to pursue their hobbies and interests both inside of the home and within the local community.

There was a new registered manager in post. Relatives, staff and health and social care professionals spoke positively about the registered manager and the changes they were making at the home. One member of staff said, “She is like a breath of fresh air.”

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.

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

Rating at last inspection: Good (the last report was published 30 September 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Enforcement: We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to good governance. Please see the action we have told the provider to take at the end of this report. We also identified a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. Notification of other incidents.

Follow up: We will return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The service had 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

People were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The registered manager shared information with the local authority when needed.

Staffing levels were sufficient to support people’s needs and people received care and support when required. People received their medicines as prescribed and the management of medicines was safe.

People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People were protected from the risks of inadequate nutrition and staff showed a good knowledge of the specialist diets required by people. Referrals were made to health care professionals when needed and staff worked to ensure people were well supported should they require medical interventions.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care and the care plans were individualised and person centred. People and their relatives were treated in a caring and respectful manner and staff delivered support in a relaxed and considerate manner. People were supported to follow their hobbies and interests.

People who used the service, or their representatives, were encouraged to be involved in decisions and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously.