Luke's Place

Updated 26 October 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 Care Act 2014.

Inspection team

This inspection was completed by 1 inspector.

Service and service type

Luke's Place is a 'care home'. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Luke’s Place 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 there was 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 feedback from the local authority and professionals who work with the service. 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 spoke and communicated with 3 people who used the service and 2 relatives about their experience of the care provided. People who used the service who were unable to talk with us used different ways of communicating such as using their body language. We spent lots of time observing how staff supported people in their day to day lives at the service.

We spoke with 8 members of staff including support workers, senior support workers, the deputy manager and the registered manager.

We reviewed a range of records. This included 3 people's care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at training data and quality assurance records.

Updated 26 October 2023

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

Luke's Place is a residential care home which can support up to four people. At the time of the inspection three people who were autistic or living with a learning disability were being supported with personal care. People have their own personalised bedrooms and bathrooms and access to shared communal areas such as a kitchen, lounges and a large garden.

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

Right Support

¿ People were not supported to pursue their interests or achieve their aspirations and goals.

¿ People were not being supported to try new things or to follow social interests and past times on a consistent basis.

¿ Reasonable adjustments were not made so that people could be fully involved in discussions about their support, including support to travel where they needed to go. Staff did not always communicate with people in their identified and preferred methods.

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

¿ The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

¿ The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their support needs.

¿ Staff supported people to take their medicines in their preferred way. People were supported to live healthy lifestyles and staff members promoted healthy choices in areas such as eating and drinking.

Right Care

¿ Staff were not promoting people to try new things which may have enhanced their wellbeing and enjoyment of life.

¿ People who had individual ways of communicating such as using symbols or body language could not always interact comfortably with staff as they did not have all the skills necessary to understand them.

¿ Staff were not being supervised to support people effectively. The registered manager was not checking staff competency to perform their job roles.

¿ People’s support plans did not fully reflect their range of needs and promote their wellbeing and enjoyment of life

¿ People were not always receiving kind and compassionate care. Staff did not always protect and respect people’s privacy and dignity.

¿ Staff knew people well as individuals, however in practice, did not support people in line with their identified likes, dislikes and preferences.

¿ Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff knew how to recognise, and report abuse and they knew how to apply it.

Right culture

¿ The management and staff team did not understand the key principles of guidance such as Right Support, Right Care, Right Culture. Audits completed at the service by management had not picked up on areas that could have been improved to help support a more positive culture. Audits had not been completed in a lot of areas.

¿ People and those important to them, were not involved in planning their support. It was unclear how staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

¿ The service had a negative culture that was at risk of becoming a closed culture. Staff were not supporting people to have a good quality of life or achieve good outcomes.

¿ When people did receive kind and compassionate care from a staff team who had got to know them as individuals, they were happy and relaxed.

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

The last rating for this service was requires improvement (report published 13 May 2022) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations. The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection. This service has been rated requires improvement or inadequate for the last ten consecutive inspections.

Why we inspected

We undertook this inspection to assess that the service was applying the principles of Right support right care right culture. This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

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

Enforcement and Recommendations

We have identified breaches in relation to staffing, person centred care and good governance at this inspection. Please see all sections of this full report. Please see the action we have told the provider to take at the end of the 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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.