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CareTech Community Services Limited - 196 High Street

Overall: Inadequate read more about inspection ratings

196 High Street, Rickmansworth, Hertfordshire, WD3 1BD (01923) 774869

Provided and run by:
CareTech Community Services Limited

Latest inspection summary

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Background to this inspection

Updated 28 September 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.

Inspection team

One inspector carried out the inspection.

Service and service type

Care Tech Community Services Limited 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 the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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

We reviewed a range of records related to 3 people's care and support. We looked at the medicine records for 2 people and 2 staff files in relation to recruitment and training. We reviewed records related to the management of the service, which included training records, safeguarding incidents, complaints, quality assurance records and a range of policies and procedures. We carried out observations of care and support. Our observations included 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 spoke with the deputy manager, team leader, 3 staff members and 3 people who lived at the home. After the inspection we contacted 3 professionals, and we received feedback from 1. We spoke with 5 relatives.

Overall inspection

Inadequate

Updated 28 September 2023

About the service

Care Tech Community Services Limited 196 High Street is a residential care home providing personal and care to up to 12 people. The service supports people with learning disabilities and autistic people. At the time of our inspection there were 6 people using the service and 6 people were on holiday.

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

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.

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; the policies and systems in the services supported this practice. People’s care was not personalised. The home was not well maintained. The provider did not have effective processes or systems in place to deal with the repairs that were needed in the home to keep people safe. The provider was struggling to recruit permanent staff which meant there was a high use of agency staff, and this impacted on how people received their day to day care and support. Medicines were administered safely. The provider had safe infection control practices. Staff understood how to raise safeguarding concerns.

Right Care:

People received kind and compassionate care. Staff did not always protect and respect people's privacy and dignity. Permanent staff understood and responded to people’s individual needs however some agency staff did demonstrate they had the necessary skills to care for people. Support plans didn't always reflect people’s interests and activities and there was a lack of activities at the home which meant some people did not participate in activities they enjoyed. People were supported to access healthcare services. People were supported to maintain balanced diets.

Right Culture:

The service was not well-led. There was no effective governance system in place to monitor the quality of the service provided to people. The provider was not learning from incidents and accidents which placed people at risk of harm. Based on our review of this service the service was not able to demonstrate how they were meeting some of the underpinning principles of Right care, Right support, Right culture.

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 good published (22 August 2018)

Why we inspected

The inspection was prompted in part by a notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about assessing risk. This inspection examined those risks.

We looked at infection and prevention 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Tech Community Services Limited 196 High Street on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of regulations in relation to person-centred care, safe care and treatment, premises and equipment and good governance.

We have sent a Regulation 17(3) Letter to the provider in relation to their failure to effectively operate systems and processes to assess, monitor and improve the quality and safety of the services provided in carrying on the regulated activities. A Regulation 17(3) Letter stipulates the improvements needed to meet breaches of regulation, seeks an action plan and requires a provider to regularly report to CQC on their progress with meeting their action plan.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.