Archived: Claremont Villas

Claremont Villas is a supported living and domiciliary care service supporting people with learning disabilities and autism. At the time of our inspection seven people were receiving support from the service. Four people lived in a house of multi-occupation. The registered manager also lived in this house. A further three people received support from Claremont Villas in their own homes in the community.

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

The service was not safe. Risks associated with people’s care and support, such as falls, were not managed safely. Poor management of environmental risks, such as fire and food hygiene, placed people at risk of harm. Opportunities to learn from adverse incidents had been missed. Safe recruitment procedures had not been followed, this meant there was a risk people may be supported by unsuitable staff. There were not enough staff to ensure people’s safety. Medicines were not managed or stored safely, this increased the risk of error or misuse. There was a risk people may not be protected from abuse. A lack of staff training and absence of any formal systems in relation to safeguarding meant there was a risk allegations of abuse may not be identified or addressed.

People were supported by staff who did not have the training or competency to ensure safe support. 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. People were at risk of inconsistent and unsafe care as their needs were not appropriately assessed or planned for and advice had not always been sought from expert health professionals.

People’s right to privacy was not always respected. People were not always supported to express their views. People gave mixed feedback about the approach of staff. Allegations had been made that staff were not kind or caring and this remained under investigation.

There was a risk people may receive support that did not meet their needs. People were not always provided with information in a way they could understand. There was a risk that people’s complaints and concerns may not be addressed. People were provided with support to follow their interests and take part in the local community and supported to keep in touch with family and friends.

The service was not well led. The provider did not have the skills or competency to run Claremont Villas safely. People's health and safety was at risk due to a failure to identify and address issues and poor practices. Information had not always been shared in an open and honest way with people, their families or other agencies.

Following our inspection, due to the level of risk, the local authority made arrangements for people to receive support from alternative care providers.

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 on 21 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safety, staff recruitment, staffing levels, staff training, dignity and respect and leadership and governance. We took urgent action to impose conditions upon the providers registration to ensure people's safety. We cancelled the providers registration which meant they were not longer able to provide a regulated services to people.

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 of 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.

The service was registered to provide personal care for people. At the time of our inspection, four people with a learning disability were supported by the provider in their own shared home.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe when being supported by staff who knew how to protect them if they suspected they were at risk of abuse or harm. The staff knew how and when to report their concerns if they suspected someone was at risk of abuse so that they could be protected.

The staff had a good understanding of the specific risks to each person and what they should do to minimise these without restricting people’s rights to undertake activities or tasks. People were involved in a range of interests and were able to choose how to spend their time and to develop and maintain relationships with their families and friends.

There were enough staff to support people. People only received support in their home during the day and there were arrangements in place for people to have additional support when needed during the night. People’s consent to care was sought and they had capacity to make important decisions. People could choose to be supported by family or an advocate when making decisions. The support plans reflected their specific needs and preferences for how they wished to be supported and were reviewed with them regularly.

Staff supported people to keep healthy and well and ensured they were able to access healthcare services when this was needed. People received support to manage and control their medicines and were prompted to take these to keep well, where this was required.

People were treated with kindness and respect and staff promoted people’s independence. People were helped to prepare and cook their own meals and they were responsible for shopping and planning their meals. People could choose their own food and drink and were supported to eat healthily.

People felt comfortable raising any issues or concerns directly with staff and there were arrangements in place to deal with people's complaints. Systems were in place to assess and monitor the quality of the service. People and staff were encouraged to raise any views about the service to consider how improvements could be made. The manager promoted an open culture which put people at the heart of the service.

We found that the service had undertaken some of the improvements it told us about in its action plan following our inspection visit in July 2013.

We found the service had improved its recruitment procedures and that the legally required information was in place.

We found staff had not received moving and handling training since our previous visit in July 2013 but there was a planned date for this training in January 2014. We saw that fire safety training had been undertaken by the manager and she told us she was trying to source more practical training. We also found that staff supervision had improved and was recorded.

Staff had not commenced qualification training at level 3 as specified in the service's action plan but the manager told us this had been applied for and the service was waiting for dates in 2014.

We saw that the service had started to establish quality assurance procedures, including compiling a survey for relatives and service users, although these were not fully operational and some of the information available was minimal.

We found the service did not have proper recruitment procedures and that information legally required before people commenced work was not available.

We found staff received essential training and their induction was useful but that some health and safety training did not occur and supervision of staff was informal.

We saw that the service did not have well established quality assurance procedures and that feedback from people was not sought properly in order to drive improvements.