Archived: The Bungalow

Updated 10 October 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by two inspectors.

Service and service type:

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. At the time of the inspection the manager had applied to become the registered manager.

Notice of inspection:

We did not give notice of our inspection as this inspection was unannounced.

What we did:

¿ Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

¿ We spoke to three people who used the service and one person’s relative.

¿ We looked at three people's support plans and the recruitment records of six staff employed by the provider as staff worked flexibly across the providers services.

¿ We viewed, medicines management, complaints, meetings minutes, health and safety assessments, accidents and incidents logs. We spoke with the provider, the manager, one team leader and one support worker.

¿ We sought feedback from relevant health and social care professionals and commissioners from the local authority on their experience of the service.

¿ At the inspection we asked the manager to send us some further information about the support for one person, contact information for relatives, information on training and the medicine policy. Some of this information was received in a timely manner, however some documents we asked for about one person’s care were not sent.

Updated 10 October 2019

About the service:

The Bungalow is a supported living service. At the time if the inspection three people were receiving a service who all lived together in one house. The service shares the same staff, office and manager as another supported living service (Grove Villa Supported Living) which is based on the same site. The Bungalow and Grove Villa Supporting Living were inspected on the same dates. The house was a single-story building based on a large site where there were two other services provided by the same provider.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question Well-led and Responsive to at least Good. We found that the provider had not undertaken all of the actions in their action plan. The service was previously Requires Improvement Responsive and in Well-led, we found that it was now Inadequate in Well-led and remains requires improvement in Responsive. All other key questions had deteriorated: Safe is now rated Inadequate, and the key questions of Effective and Caring are rated Requires Improvement.

There was no management oversight of the service and no oversight by the provider. For example, there was a lack of auditing, complaints were not always recorded, and staff performance was not monitored. This meant that there was a risk that people were not always receiving the high quality, person centred, safe service they should expect the receive.

People were at risk of harm. Risks to people were not always assessed, managed or monitored safely. This impacted on individual’s safety in their day to day lives. People could not be assured that the provider, manager or staff would provide the right support to keep them safe from harm. People were not always receiving their medicines as prescribed which could have a possible impact on their health or well-being. People were not always protected from risks and when things went wrong there was a lack of action and learning to ensure that concerns did not escalate or happen again. The service did not always report concerns to safeguarding or CQC. This meant that neither CQC nor the local authority safeguarding team could check that staff had protected people from the risk of abuse or other harm at the time of the incident.

Staff did not have the training they needed to support people and undertake some of the tasks they were asked to do. Staff were not up to date with best practice which could have an impact on people’s safety. For example, staff were supporting people to cook for themselves but did not always have food hygiene training. There were also concerns about the providers staff recruitment practices, for example some staff had been recruited without the references the provider’s policy stated that were required.

People were happy with the service they received and told us that they liked the regular staff. People led busy lives and we often out. They were able to be independent at the service and staff supported and encouraged them to be so. However, people were not always supported to keep their home clean and we made a recommendation about this. When people were unwell they were assisted to access healthcare and people were supported to remain active and to live healthily.

People did not have care plans in place which fully described their support needs, preferences and interests. When people’s needs and wishes changed, their care plans had not been updated to reflect this. There were enough staff to support people: Regular staff knew people well and knew people’s likes and dislikes. However, some non-regular staff provided support for people and the absence of accurate care plans and risk assessments meant people could not always be assured their needs would be known or met. The service had not asked people about their preferences for the end of their life. This meant that staff may not have known people’s preferences.

The outcomes for people using the service did not always reflect the principles and values of Registering the Right Support; Although staff recognised that people had the capacity to make day to day choices, people did not always receive the right support to keep them safe. People were supported to be independent and undertake daily living activities. People were engaging in the community, for example through attending clubs, accessing local shops and visiting local pubs.

We found a number of breaches of the regulations. The service did not meet the characteristics of Good in any area; more information is in the full report.

Rating at last inspection:

At the last inspection on the 31 May 2018 the service was rated Requires Improvement for the second consecutive time.

Why we inspected:

This inspection was brought forward due to information of concern.

Enforcement and Follow up:

The overall rating for this service is ‘Inadequate’ and the service is therefore 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.