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The local authority has identified this service as suitable to care for people discharged from hospital with a positive coronavirus (COVID-19) test result. We have checked it meets the infection prevention and control standards we expect. Find out more about these checks

Inspection Summary


Overall summary & rating

Good

Updated 18 August 2021

About the service

St Michaels House is a specialised short break service that provides respite care for people with a learning disability and/or physical disability. Hertfordshire County Council is registered to provide accommodation and care at St Michaels House for up to 12 people at any one time. At the time of the inspection there were six people using the service.

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

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

Based on our review of safe and well-led the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Staff did not have specific training to support people with learning disability and autism. We observed a staff member speaking to people that did not promote dignity and respect. Care plans identified peoples support needs and were being developed to ensure they maximised people’s choice and control. The registered manager acknowledged this and was putting actions into place to educate staff.

Staff received training that covered mandatory training, however, did not receive training that was required for people’s specific support needs. This was actioned immediately following the inspection. And staff had their competency assessed. Staff had received training in infection control practices and personal protective equipment was provided for them.

People and their relatives felt the care provided was safe and risks were managed appropriately. This was because staff knew people well, and systems were in place to report any concerns. Risks to people's health, safety and well-being were assessed. People's medicines were managed safely. People were supported by a staff team, who had been safely recruited.

Systems were in place for reporting and responding to accidents and incidents. Incidents were followed up and prompt action taken to ensure people were safe and to prevent reoccurrence.

People and their relatives praised the staff team. Staff had a good understanding of the people they supported. They took the time to get to know people's individual likes and dislikes. People and their relatives told us they would be confident to raise any concerns with the management team.

People, their relatives and staff members and professionals spoke highly of the registered manager and told us that they were available and supportive. The registered manager had a good understanding of their responsibilities towards the people they supported and was dedicated to continuing to improve the service. A governance system was established, which included various audits and the monitoring of safeguarding concerns, complaints, accidents and incidences. Formal action plans however had not been developed for ongoing monitoring.

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 March 2020).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about staff skills, training and the culture of the service. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern staff skills and training, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

We looked at infection prevention and control measures under the Safe key question. We look at this

Inspection areas

Safe

Good

Updated 18 August 2021

The service was safe.

Details are in our safe findings below.

Effective

Good

Updated 18 August 2021

Caring

Good

Updated 18 August 2021

Responsive

Good

Updated 18 August 2021

Well-led

Requires improvement

Updated 18 August 2021

The service was not always well-led.

Details are in our well-led findings below