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Michael Batt Foundation Domiciliary Care Services

Overall: Inadequate read more about inspection ratings

First Floor, 3 The Crescent, Plymouth, PL1 3AB (01752) 310531

Provided and run by:
Michael Batt Foundation

Latest inspection summary

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Background to this inspection

Updated 11 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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses. The service also provides care and support to people living in 2 ‘supported living’ settings, 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.

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.

Inspection activity started on 12 July 2023 and ended on 21 July 2023. We visited the location’s office on 12, 14 and 21 July 2023.

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 with the registered manager, the business manager and the nominated individual. A nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 6 people's care records We looked at 6 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including medication records, accidents and incidents and training records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with, 4 relatives and 4 care staff.

Overall inspection

Inadequate

Updated 11 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

Michael Batt Foundation Domiciliary Care Services (hereafter The Michael Batt Foundation) is a Domiciliary Care Agency that provides support to people with a learning disability, autistic people or who have multiple health needs associated with their mental health. The service was providing personal care to 12 people at the time of the inspection.

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

Right Support:

The Model of Care provided by The Michael Batt Foundation was not safe. 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 and in their best interests; the policies and systems in the service did not support this practice.

Care plans and risk assessments relating to the health, safety and welfare of people were not kept under regular review. Some peoples risk assessments were outdated and did not reflect their current risk to themselves and/ or others.

People were placed at the risk of not receiving safe care as there was not an effective structured system to ensure staff had been deployed effectively. Medicines were not always managed safely and in line with the National Institute for Health and Care Excellence (NICE) guidance Managing medicines for adults receiving social care in the community.

Right Care:

The Model of Care provided by The Michael Batt Foundation was not person-centred and did not promote people’s dignity and human rights. The language sometimes used by staff to describe people within their care notes, was outdated and disrespectful. Staff were able to describe the actions they could take if they had safeguarding concerns for the people they supported. However, records showed appropriate action had not always been taken.

There was an absence of a person-centred care planning review process, and we could not be assured that peoples care plans were up to date and contained sufficient information to guide staff in providing good quality personalised care. People were not supported to live their lives according to their preferred routines. There was a lack of sufficient evidence to show that all reasonable steps had been taken to re-engage people in meaningful activities and social interactions following the COVID19 Pandemic.

Right Culture:

Restrictive practices, poor application and understanding of the Mental Capacity (MCA), a lack of openness and transparency and inadequate governance and oversight had helped to create a 'closed culture' at The Michael Batt Foundation. A 'closed culture' is a poor culture that can lead to harm, including human rights breaches such as abuse. In these services, people are more likely to be at risk of deliberate or unintentional harm.

It was evident from a review of the data and information held by the provider and our findings throughout our inspection that staff did not receive regular, effective supervision and support. The registered manager was aware of their regulatory responsibilities such as submitting statutory notifications but failed to carry this out.

The findings of our inspection identified a culture that was not based on learning. This meant that when things had gone wrong, the potential for re-occurrence was inevitable because there was no action taken to review, investigate and reflect on incidents.

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 9 May 2018)

Why we inspected

The inspection was prompted in part by information shared with CQC about a series of incidents which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk, MCA, and unlawful restraint. This inspection examined those risks.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. However, further concerns and risks were identified so a decision was made to carry out a comprehensive inspection to include the key questions caring and responsive.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding people from abuse, consent, dignity and respect, person centred care, notifications of other incidents and governance.

Please see the action we have told the provider to take at the end of this report.

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.

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.