Paul Murphy Centre

The Paul Murphy Centre is a residential care home providing personal care for up to 8 people with a learning disability and / or autism. At the time of our inspection, 5 people were living at the Paul Murphy Centre. There was no one accessing the respite service on the day of our inspection however some people were accessing this element of the service over the weekend.

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

Right Support: Medicines were received, stored, and disposed of safely. However, staff involved in handling medicines did not always follow the home’s own policies for medicines record keeping and administration. This meant that we could not be assured that medicines were given safely as prescribed.

Support that was provided was person centred.

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.

Right Care: People received kind and person-centred care. Staff responded to individuals needs well and supported them in a person centred manner. The service worked well with external health care professionals where needed.

Right Culture: People received good quality care from the service and the service knew individuals well and responded well to their needs. Individuals were involved in the service delivery and also planning of their care. The service engaged those who lived and worked at the service and acted on feedback. Feedback from relatives was very positive.

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 27 March 2021)

At this inspection we found the provider to be in breach of one regulation. The service remains rated requires improvement.

Why we inspected

We carried out an announced/ unannounced comprehensive inspection of this service on 27 March 2021. A breach of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Paul Murphy Centre on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to safe use of medicines at this inspection. We also made a recommendation regarding the providers governance systems.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Paul Murphy Centre is a residential care home providing personal care for up to eight people with a learning disability and / or autism. Four beds were allocated for people to access short respite stays at the home. At the time of our inspection, two people were living at the Paul Murphy Centre. There was no one accessing the respite service on the day of our inspection.

The home is an adapted, refurbished property with twelve bedrooms, some of which are en-suite. There are two shared lounges and a shared kitchen / diner. There is an accessible garden to the rear.

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

The deputy manager reviewed a range of documents each month. However; the provider had not had robust oversight of the service to support the deputy manager. The provider had not ensured regular checks of the fire safety systems had been completed. Plans were in place to improve the quality assurance systems.

Relatives were positive about the support provided, the communication with the staff team and felt their relatives were safe at the Paul Murphy Centre. Staff were also positive about working at the service and the support they received, especially from the deputy manager. Formal staff supervisions and meetings were planned for the coming year.

The risks people may face had been assessed and guidance was in place for staff to manage these known risks. People received their medicines as prescribed.

There were enough staff on duty to meet people’s needs. The number of staff on shift varied depending on how many people were at the home for a respite stay. Staff had been safely recruited.

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 able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

People’s needs were assessed to ensure people received the support they needed. These were reviewed with their relatives before each respite stay to ensure any changes in needs were known.

Right care:

Support was person-centred and promoted people’s dignity and privacy.

Right culture:

Staff were positive about working with people at the Paul Murphy Centre. 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. People were supported to access the community whenever possible, considering the COVID-19 restrictions.

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 15 April 2019).

Why we inspected

We received concerns in relation to the management of medicines, staffing and the management and oversight of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Paul Murphy Centre on our website at www.cqc.org.uk.

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.

We have identified breaches in relation to the quality assurance systems and provider oversight at this inspection.

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 for 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.

¿ The Paul Murphy Centre is a short breaks respite service for people with a learning disability, autism and physical disabilities, registered to provide personal care for up to eight people staying at any one time.

¿ There were twenty people in total using the service, with four people staying at the time of our inspection.

¿ The Centre is an adapted, refurbished property with twelve bedrooms, some of which are en-suite. There are two shared lounges and a shared kitchen / diner. There is an accessible garden to the rear.

¿ The service was first registered with the CQC in May 2018. They then re-registered in October 2018 due to a legal entity change for the provider. There were no changes in the management structure for the provider or the service itself.

People’s experience of using this service:

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

¿ People and their relatives were positive about the support provided by the Paul Murphy Centre. People looked forward to their visits and felt safe with the home’s staff. They said the staff were kind and caring and they were positive about how the registered manager responded to any comments or concerns they had.

¿ People’s needs were assessed and care plans and risk assessments written and reviewed for each person.

¿ Staff knew who was due to stay at the home in advance so could refresh themselves about different people’s needs prior to their visit. The computer care planning system also gave staff key information about their needs and the support required via hand-held devices that each member of staff had when on shift.

¿ Staff received the training and support they required to complete their roles. Any specific training required to meet people’s needs was completed before they stayed at the service.

¿ Staff knew people and their needs well.

¿ Staff enjoyed working at the service and said the registered manager and team leaders were approachable. The provider had developed a clear set of principles for a person-centred service which were promoted to the staff team during supervisions and team meetings.

¿ People received their medicines as prescribed. All medicines were booked in by staff and relatives at the start of their visit. Information about any ‘as required’ was obtained during the pre-admission assessment. Following the inspection, the non-verbal indicators that ‘as required’ medicines should be administered was written into a formal care plan so that all staff would be aware of them.

¿ People participated in a range of activities with staff support depending on what they wanted to do. The registered manager developed a form to record what people had done during their respite stay and what they would like to do on their next visit.

¿ The home was furnished and decorated to a high standard. First floor bedrooms had track hoists in situ and bathrooms were fully accessible.

¿ The service was flexible in terms of the layout of the bedrooms and the staffing to meet each person’s individual needs.

¿ The registered manager and operations manager completed a series of audits. An action plan was written if any issues were found. These had been completed within the agreed timescales.

¿ The fire alarm was checked every week and a three-monthly audit of the fire procedures was carried out. Emergency lighting and fire doors were visually checked. Following the inspection additional training was provided for a staff member to test the emergency lighting using the emergency glass break.

¿ Testing for Legionnaires was completed, unused water taps were flushed and some water temperature checks were made. Additional water temperature checks for taps regulated with a thermostatic valve were introduced following our inspection.

¿ All incidents, accidents and complaints were investigated and analysed to reduce the likelihood of the same issue happening again.

Rating at last inspection: This was the first inspection at the Paul Murphy Centre since it had first registered with the CQC in May 2018.

Why we inspected: This was a planned inspection in line with CQC’s guidelines to inspect all new services within 12 months of registration.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk