Background to this inspection
Updated
28 March 2024
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 Care Act 2014.
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
One inspector carried out the inspection. An assistant inspector carried out phone calls to relatives.
Service and service type
CareTech Community Services Limited- 19 Wheelwright Road 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. CareTech Community Services- 19 Wheelwright Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
We visited the service on 31 January 2022 and 23 February 2022. The inspection activity concluded on 3 March 2022.
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. 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 met all the people living at the service, spoke with one person and communicated with two other people. People who lived at the service who were unable to talk with us used differing means of communication including Makaton, pictures, photos and their body language. We spoke with one relative about their experience of the care provided.
We spoke with six members of staff including the registered manager, locality manager and four members of care staff.
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. This included two people’s care records and two medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, training data and quality assurance records were reviewed.
Updated
28 March 2024
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
CareTech Community Services Limited - 19 Wheelwright Road is a residential care home providing personal care to six people at the time of the inspection. The service can support up to six people.
People’s experience of using this service and what we found
Right Support
¿ The provider had not always assessed, monitored and mitigated the risks associated with people’s care.
¿ Staff had supported people with their daily medicines in a way that achieved the best possible health outcome. We found that monitoring of ‘as required’ medicines required further improvement.
¿ The provider ensured the home’s environment was clean, well equipped and well-furnished.
¿ People had a choice about their living environment and were able to personalise their rooms.
¿ Staff enabled people to access specialist health and social care support in the community.
¿ Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
¿ Staff enabled people to access specialist health and social care support in the community.
Right Care
¿ People had not always been supported to take part in activities and pursue interests based on their individual preferences.
¿ People had not been supported to develop goals and aspirations based on their individual preferences.
¿ People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
¿ Staff understood how to protect people from poor care and abuse. The provider worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
¿ The provider had enough appropriately skilled staff to meet people’s needs and keep them safe.
Right culture
¿ Staff evaluated the quality of support provided to people. However, people had not always been involved in these reviews.
¿ The provider enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views.
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 and update
Our last inspection of the service was a focussed inspection of Safe and Well Led and the service was rated requires improvement (published 23 October 2020). There were 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 improvements had not been sufficiently made and the provider remains in breach of regulation. The service had been rated requires improvement for the last three consecutive inspections.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
This inspection was prompted in part by a review of information we held about this service.
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 have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well Led sections of this full report.
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 person centred care, safe care and treatment and systems to ensure safe and good quality care at this inspection.
Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.