Overcliffe House

Updated 19 January 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 carried out by one inspector.

Service and service type

Overcliffe House 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. Overcliffe House 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not 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 and received feedback from the local authority. 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 joined 2 people for breakfast and were introduced to 3 other people who used the service. We spoke with 3 relatives to gain their views about the quality of the service. We talked with 5 members of staff including the manager, deputy manager, senior carer, a carer and deputy area manager.

We reviewed a range of records. This included 2 people’s care records and medication records. We looked at 3 staff files in relation to recruitment. We also looked at staff training and meetings. A variety of records relating to the management of the service were reviewed including accidents and incidents and quality checks and audits.

Updated 19 January 2023

About the service

Overcliffe House is registered with the Care Quality Commission as a residential care home providing the regulated activity of personal care and accommodation for up to twelve adults with a learning disability and/or autistic people. At the time of the inspection there were 7 people using the service. The service consisted of two houses next door to one another with 2 people living in one house and 5 people in the other house. Each house had a communal kitchen and lounge and a shared garden to the rear. People had varying degrees of independence and some people had lived at the service for over thirty years. Most people had limited verbal communication so were unable to provide feedback by speaking to us directly.

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.

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

Right Support: People were not always supported to have maximum choice and control of their lives and it could not be assured staff supported them in the least restrictive way possible and in their best interests; staff did not always follow the policies and systems in the service to support best practice. Mental capacity assessments had not always been undertaken to assess if people had the capacity to make specific decisions. It could not be assured the conditions in people’s DoLS were met as the service did not monitor them for compliance.

The service gave people care and support in a clean environment, but the décor did not always meet people’s expectations. The provider was working with the landlord to make improvements.

Staff enabled people to access specialist health and social care support in the community. However, only half the staff team had received updated training or competency checks in how to administer medicines safely. Staff prepared food and drink to meet people’s dietary needs and requirements. Staff supported people to take part in activities and pursue their interests in their local area. They had access to day services provided specifically for autistic people. Staff communicated with people in ways that met their needs and planed for when they may experience periods of distress and anxiety.

Right Care: Information about people’s care, treatment and support was easy to access to ensure people’s wellbeing was promoted. People received kind and compassionate care from staff who understood and responded to people’s individual needs.

People and relatives were positive about the quality of the service. People indicated by the ‘thumbs up’ sign that staff gave the support they needed. Relatives said staff were caring and helped ensure people followed a routine that made them feel safe.

People were supported by staff who understood the wide range of strengths, impairments or sensitivities autistic people may have. People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language) and pictures, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

There were enough staff to meet people’s needs and keep them safe. Staff understood how to protect people from poor care and abuse.

Right Culture: Quality assurance and monitoring systems were not always effective in identify shortfalls and improving the service for the people who used it. People’s family members were not always fully involved in providing feedback about the service so their views could be acted upon.

People benefitted from the open and positive culture of the service where the management team was approachable and listened and responded to 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

The last rating for this service was Good (published 9 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service and in part due to concerns received about care planning, risk assessments and oversight of the service.

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.

Enforcement and Recommendations

We have identified breaches in relation to monitoring the quality of the service, staff training in medicines, recruitment of agency staff and assessing people’s capacity to make at this inspection.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

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

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.