Background to this inspection
Updated
4 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
Our inspection was completed by 2 inspectors.
Service and service type
Inglewood 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. Inglewood 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 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 the registered manager was absent from the service. We were supported on the inspected by a regional manager.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We also asked for feedback from the local authority and spoke with 2 people using the service.
During the inspection
We spoke with 4 people who used the service about their experience of the care provided. We called and spoke with 3 relatives.
We reviewed a range of records including 5 people's care plans, daily care notes, medication records, safeguarding records and incidents. We reviewed a variety of records relating to the management of the service including supervisions and spot checks. We spoke with 5 members of staff including the regional manager and care staff.
Updated
4 January 2023
About the service
Inglewood House provides accommodation and personal care for up to 12 people who have a learning disability and autism. At the time of our inspection, there were 9 people living at the service. The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.
People’s experience of using this service and what we found
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. We considered this guidance as there were people using the service who had a learning disability.
Right Support: Care plans were not always up to date or reflective of people’s current needs. However, staff we spoke with did have an understanding of the support people needed. There was limited information on people’s life histories and there was a lack of monthly key worker meetings. The audits at the service were not always robust and did not identify some of the concerns we found. Health care appointments were not always followed up or care records updated to reflect health care information. We have made a recommendation around this.
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.
Right Care: Staff treated people with dignity, courtesy and kindness. They respected people’s choices and encouraged people to live independent lives. People told us they had developed positive and supportive relationships with staff. Risks associated with people’s care were managed in a safe way. People’s medicines were reviewed regularly and managed well.
Right Culture: Staff and the management team showed a dedication to support people appropriately. People and their families fed back they felt the management team was supportive and listened to their views. Complaints were listened to and acted upon.
Rating at last inspection
The last rating for this service was inadequate (published 20 May 2022). We also undertook a targeted but not rated inspection (published 09 November 2022).
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the effective, 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.
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.