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Lilac Cottage Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 24 January 2020

About the service

Lilac Cottage is a residential care home providing personal care to five people at the time of inspection. The service can support up to seven people with different health and care needs, including learning disabilities and/ or autism, in one adapted building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. There was some mixed feedback about the consistent implementation of the principles and the adaptation of the service to meet individual needs.

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

People and staff told us that the service had gone through a period of unsettlement but was stabilising again. People and staff were pleased that the registered manager was back at Lilac Cottage full-time. The provider had seconded the registered manager elsewhere and made alternative management arrangements for the service. However, in the absence of the registered manager, there had been some inconsistencies in management arrangements and effective provider oversight had not always been ensured. This had led to a deterioration in some areas, including the safety and quality of people’s care, but this was now improving. Staff comments included, “When I first came here, things were up the wall. With [registered manager] back, we are progressing a lot.” The provider had identified these gaps; however, it was clear their lessons learned from events included the need to ensure more timely, robust oversight and prevent recurrence of issues.

The report highlights issues experienced by the service during an unsettled time and issues we identified at the start of our visit. We found a breach of regulations, as the Care Quality Commission (CQC) had not always been notified of specific events. However, we also took into consideration progress made and the reintroduction of stability with the presence of a dedicated registered manager. This provided mitigation to potential further breaches of regulation. We therefore made recommendations regarding safeguarding oversight, risk management and record-keeping, staffing and governance.

Record-keeping and quality processes had needed to be more effective, particularly to ensure safety and risk management information were up to date. We received some concerns regarding staffing. People felt that there were not always enough staff and that many had left. The registered manager was addressing this through recruitment. Staff felt that colleague numbers and reliability were stabilising again.

The service applied the principles the principles and values of Registering the Right Support and other best practice guidance, but some improvements were needed to the consistency of this. The principles ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. It was noted that an aspect of service adaptation did not always meet the individual needs of a person. We considered that partnership working with people, families and stakeholders at times needed to be more robust. This was to ensure there was an agreement on how individual needs would be met appropriately and establish a shared vision of support and expectations.

However, following their recent full-time return the registered manager had brought back with them their passion to drive up the quality of people’s care. Overall, people told us they felt safe living at Lilac Cottage and thought, “[Registered manager] is sound” or showed us in their own ways how much they liked them. Positive feedback from some relatives told us, “I generally think it is a great service, the staff are very supportive of [name] and their family” and “[Name] is safe and well

Inspection areas

Safe

Requires improvement

Updated 24 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 24 January 2020

Caring

Good

Updated 24 January 2020

Responsive

Good

Updated 24 January 2020

Well-led

Requires improvement

Updated 24 January 2020

The service was not always well-led.

Details are in our well-led findings below.