Agnes House

Updated 7 August 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. 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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Agnes house is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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.

Notice of inspection

We gave the service one days’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

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 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

Due to the needs of the people who lived at the service we were unable to speak to them. However, we spoke with one relative about their experience of the care provided and five members of staff including the registered manager, senior care worker and care workers.

We reviewed a range of records. This included two people’s care records and two medication records. We looked at three 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 one professional who regularly visited the service and one relative.

Updated 7 August 2019

About the service

Agnes house is a residential care home providing personal care to two people aged 18 and over at the time of the inspection. The service is registered to support up to five people who may have a learning disability. The service has two buildings which accommodate up to five people, however at the time of the inspection there was nobody residing in one of the buildings.

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. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. However, we have found improvements are needed.

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

The building required maintenance to meet the needs of people living in the service. Training staff received was not always up to date, which meant staffs skills and knowledge was not updated in a timely basis. We found people had enough to eat and drink.

We have made a recommendation about mental capacity assessments. 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; however, the policies and systems in the service did not support this practice.

We have made a recommendation around involvement in care planning. People were supported by staff who knew them well and promoted their independence.

Governance systems required strengthening. Audits were completed but did not always identify issues that needed addressing and when problems had been identified, these were not always addressed in a timely way. The culture within the service did not always provide positive outcomes for people. However, the provider did work in partnership with other professionals.

People were protected from the risk of potential abuse. Staff were aware of the different types of abuse and knew how to report their concerns if necessary. People received their medicines safely and were protected from the risk of cross infection as staff wore personal protective equipment. Staff were safely recruited, and people received support in line with their commissioned hours.

People received personalise care that was responsive to their needs and accessed the community regularly. The provider was working in line with the Accessible Information Standards and although nobody was receiving end of life support the provider had systems in place to address this situation should it arise.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and remain as independent as possible.

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 23 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.