Background to this inspection
Updated
22 March 2022
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Two Inspectors carried out the inspection.
Service and service type
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
The Mowhay is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Notice of inspection
This inspection was unannounced.
What we did before 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with the four people who used the service and three relatives about their experience of the care provided.
We spoke with five members of staff including the registered manager.
We reviewed a range of records. This included two people’s care records and medication records. We looked at two 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 reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with five members of staff and five professionals who had worked with the service.
Updated
22 March 2022
About the service
The Mowhay is a care home for up to five autistic people. At the time of the inspection four people were living at the service. Two people had their own self-contained accommodation, one in a separate annexe and one in a basement flat. The other two people shared a kitchen and lounge in the main house. The service is part of the Spectrum group who run several similar services throughout Cornwall.
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, effective and well-led the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support
People living at The Mowhay had different needs and required variable levels of support. Peoples experience of living at the service varied.
When some people experienced periods of distress there was a lack of guidance on how to support them to manage this.
The Mowhay was a pleasant, well-furnished and welcoming environment that met people’s physical and sensory needs.
The registered manager and staff had recently started working with specialist external healthcare professionals to develop strategies for supporting people.
Staff encouraged and supported people to pursue their interests in their local area.
Right Care
There were enough staff to meet people’s needs. Staff respected people’s diverse needs and recognised their individuality.
Staff recorded when people had become distressed and put themselves at risk of harm. The information was collated by the organisations behavioural team but this had not led to practical guidance for staff to help them support people when they were distressed.
Staff continually assessed risks in the community to try and help people avoid situations which might lead to them becoming distressed.
Right Culture
Some people were at risk of harm because effective strategies had not been developed to support them when they were anxious.
People were supported by staff who knew them well and put their needs first.
People were at ease in their environment. They approached staff freely and there was a relaxed and friendly atmosphere.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 (published 4 September 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found some improvements had been made and the provider was no longer in breach of the regulations identified at the last inspection.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
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.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified a breach of the regulations in relation to supporting people to stay safe.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.