We carried out a review of the data available to us about Flourishgate Care Services Barking on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Flourishgate Care Services Barking, you can give feedback on this service.
Flourishgate Care Services Barking provides personal care to people with learning disabilities or mental health needs in a supported living service. The service can support up to five people and at the time of the inspection, two people were using the service. People lived in shared houses and flats that were in residential areas.
People’s experience of using this service
Improvements had been made in the service following our last inspection in January 2021. The provider had developed more robust quality assurance systems to monitor the safety and quality of the service. However, these improvements would need to be sustained and remain consistent over a period of time.
People were protected from the risk of abuse. The provider’s safeguarding procedures included procedures for adults and young people. Staff were trained in how to identify abuse and report it. Risks to people were assessed and mitigated against. Staffing levels were suitable to support people in their own homes. Staff were recruited safely to ensure they could support people appropriately. Accidents and incidents were reviewed and analysed to learn lessons and help prevent their re-occurrence. Procedures to prevent and control the spread of infections were in place. Medicines were managed safely.
Staff were supported by the registered manager. They received training and ongoing supervision to maintain their skills and development. People were able to choose their food and drink preferences and were supported to attend healthcare appointments. Staff respected people’s privacy and treated them with kindness. People’s dignity and independence was maintained. They had developed positive relationships with staff. They were supported by staff to maintain relationships with family and friends to help avoid social isolation.
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.
Care plans were personalised to meet the needs and preferences of people. There was a complaints process for people and their relatives to use. People were provided information in a format they could understand. Their communication needs were understood by staff. Feedback was sought from people and relatives to help make continuous improvements to the service.
We expect health and social care providers to guarantee 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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• People had choice and control of how their care and support was delivered to them. They were supported to live as independently as possible in their own homes.
Right care:
• Staff supported people in a person-centred way and promoted their dignity, privacy and human rights.
Right culture:
• The values and attitudes of managers and staff encouraged people to feel empowered in their daily lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
At the last inspection, the service was rated Inadequate (report published 19 April 2021). There were multiple breaches of regulation and we issued a Warning Notice to the provider.
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 improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 19 April 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating and to check whether the Warning Notice we previously served, in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, had been met.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Flourishgate Care Services Barking on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service. If we receive any concerning information we may inspect sooner.
Flourishgate Care Services Ltd provides personal care to people with learning disabilities or mental health needs in a supported living service. The service can support up to five people and at the time of the inspection, three people were using the service. People lived in shared flats in a residential area.
People’s experience of using this service and what we found
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.
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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not fully able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care and the environment was not suitable for all people because the service did not fully consider if their needs could be met and if it was safe for them to be placed in the service.
We found that staff were kind and supported people to maintain their independence. Staff respected people’s privacy and supported them to avoid social isolation. However, the attitudes and behaviours of leaders and staff required further reflection to ensure the service was safe and suitable for all people that used it. Managers did not always follow best practice to collaborate with health and social care professionals when making decisions about people’s support requirements. The provider told us they would work to improve the culture and standards of the service so that people received the right care and right support.
The service was not safe because it was registered to support children and young people but there were no child protection procedures to help protect them from abuse. There were procedures for safeguarding adults and staff were aware of these.
Staff did not have sufficient training to ensure they had the right skills to support people whose behaviour could challenge. People were not assessed appropriately prior to them receiving support from the service to ensure their needs could be met. This meant their safety was being put at risk.
There were significant shortfalls in the management of the service to assess, monitor and mitigate risks to people. The provider did not follow procedures adequately enough to ensure the service was safe. Risks to people were not assessed and monitored effectively. Systems in the service did not enable suitable assessments of people's needs to be carried out when they were referred to the service at short notice. Incidents and accidents in the service were not appropriately reviewed and analysed to prevent reoccurrence. The provider had delayed notifying the Care Quality Commission of a serious incident that occurred in the service. Providers are required to notify the CQC of incidents without delay but the provider sent their notification after a two week delay.
Staff followed infection control procedures and people were protected from the risk of infections such as Covid-19. There were suitable numbers of staff in the service and they were recruited safely. Staff told us they were supported by the registered manager but they had not received formal supervision to discuss their performance and any concerns they had.
People maintained their health and nutrition with food and drink of their choice. They were supported to take their medicines. People’s communication needs were assessed. People were supported to avoid social isolation and follow their interests. There was a complaints procedure for people to use. There were systems to obtain people's feedback about the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 15/01/2019 and this is the first inspection.
Why we inspected
The inspection was prompted in part by notification of a specific incident, following which a person using the service may have been harmed. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident. The information CQC received about the incident indicated concerns about the management of risks to people in the service and the level of staff training. This inspection examined those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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 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.