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21 Lucerne Road Requires improvement

We are carrying out a review of quality at 21 Lucerne Road. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 February 2019

This inspection took place on 6 December 2018 and was unannounced. At our last inspection in April 2017 we found the service met all the regulations we inspected. During this inspection we found two breaches of the regulations and other areas of practice which required improvement. The service is rated "Requires improvement" overall. This is the first time the service has been rated "Requires improvement."

21 Lucerne Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to accommodate up to four people with learning disabilities. At the time of our inspection there were three people living at 21 Lucerne Road.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was also the provider and had managed the service since first registration with the CQC.

The care provided was not sufficiently developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism living in the home were not fully living as ordinary a life as any citizen. People had limited opportunities to participate in activities go out in the community. Furthermore, the registered manager and staff had not refreshed their knowledge of the Mental Capacity Act (MCA) 2005 and therefore did not have a clear understanding of how the MCA applied to people as their circumstances changed. 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; the lack of procedures and systems in the service supported this practice.

Staff received training and supervision but the scope of both could be further developed to better meet the needs of people and staff. People told us they felt safe living at 21 Lucerne Road and with the way they were supported by staff. There were arrangements in place to help protect people from the risk of abuse. Staff knew how to identify potential abuse and how to report any concerns. People knew how to make a complaint.

Risks to people’s health, safety and well-being were assessed and management plans devised to guide staff on how to protect them from harm. However, we found that people's care records including their risk assessments were not always fully completed or accurate. Additionally, more needed to be done to ensure information regarding people's care was in a format which was accessible to people.

People told us staff were caring and kind to them; they were satisfied with the quality of care provided. Staff respected people’s privacy and dignity and treated them with respect. Relatives and other visitors were made to feel welcome and told us they were free to visit people at any time. Staff knew people well and understood their communication needs. There were sufficient staff recruited in a safe way to provide care and support to people.

People received their medicines as prescribed. People had access to external health care professionals to maintain their health. People had sufficient food and drink to meet their nutritional needs. People told us they enjoyed the meals provided.

There was not a system in place to ensure that people's views were obtained and used to make improvements if needed. There were limited systems in place to assess and monitor the quality of service provided and the systems which were in pla

Inspection areas

Safe

Good

Updated 13 February 2019

The service was safe.

People received their prescribed medicines when they needed them. People were protected from the risk of infection.

There were enough suitable staff to support people. Staff knew how to recognise and report any concerns they had in order to protect people from the risk of abuse or harm. The provider had taken appropriate steps to protect people from the risks of being cared for by unfit or unsuitable staff.

Staff knew how to keep people safe from harm at home and in the community.

Effective

Requires improvement

Updated 13 February 2019

Some aspects of the service were not effective.

Staff did not fully understand how the main principles of the Mental Capacity Act (MCA) 2005 applied to the changing needs of people. This meant that people were restricted without the relevant authorisations being in place.

Staff had received relevant training but required further training to meet the specific needs of people.

People had a sufficient amount to eat and drink. People were supported to maintain their health.

Caring

Good

Updated 13 February 2019

The service was caring.

People and relatives told us staff were caring and kind to people.

Staff respected people�s privacy and dignity.

Responsive

Requires improvement

Updated 13 February 2019

Some aspects of the service were not responsive to people's needs.

The provider did not always ensure that people were supported to follow their interests at home or in the wider community.

More needed to be done to ensure information regarding people's care was in a format which was accessible to people.

People were satisfied with the care they received and knew how to make a complaint.

There was an appropriate complaints policy and procedure in place.

Well-led

Requires improvement

Updated 13 February 2019

The service was not well-led.

The registered manager had not kept abreast of developments in providing adult social care.

People's records were not fully completed or accurate.

The provider had not established and did not operate effective systems to assess and monitor the quality of care people received.