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We are carrying out a review of quality at Gate House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 20 February 2021

About the service

Gate House is a residential care home providing accommodation and personal care to four people with a learning disability at the time of the inspection. The service can support up to seven people.

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

People were not protected from harm and were at risk of abuse from other people and staff. People had been unlawfully restrained by staff. Staff did not have the skills or competencies to support people when they were distressed or to support them proactively to manage their behaviours. Incidents were not reported to the relevant professional stakeholders. The provider had failed to introduce additional measures to reduce repeated incidents or learn lessons. The registered manager and provider had poor oversight of incidents and had allowed people to be harmed by one another and staff.

There was a poor culture within the service which was not person centred. People were restricted in their home, for example they were not allowed in certain areas of their home and could only have snacks at specific times of the day. Staff, the registered manager and provider were not open, honest or transparent when things went wrong. The registered manager and nominated individual failed to meet their regulatory requirements.

People’s views had not been sought since they moved into the service, they were not encouraged to plan their care or make decisions about the service. The providers systems for overseeing the service were ineffective and not robust.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

The model of care setting did not maximise people’s choice, control and Independence.

Right care:

Care was not person-centred and did not promote people’s dignity, privacy and human Rights.

Right culture:

Ethos, values, attitudes and behaviours of leaders and care staff did not ensure people using services could lead confident, inclusive and empowered lives.

This meant people were placed at harm; had unnecessary restrictions placed on them and did not receive person centred care. The provider had not acted or taken any measures to mitigate the risk of harm to people or support people to live with choice or independence.

Following this inspection we worked closely with Local Authorities to ensure people were safeguarded from on-going harm. Three people were supported to move out of Gate House. There is currently no one living at Gate House.

Immediately following this inspection the nominated individual of this service changed.

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 13 December 2019).

Why we inspected

We received concerns in relation to incidents and allegations of abuse. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Inadequate. This is based on the findings at this inspect

Inspection areas

Safe

Inadequate

Updated 20 February 2021

The service was not safe.

Effective

Good

Updated 20 February 2021

Caring

Good

Updated 20 February 2021

Responsive

Good

Updated 20 February 2021

Well-led

Inadequate

Updated 20 February 2021

The service was not well-led.