We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it. About the service
The Firefly Club is a residential care home providing personal care and accommodation to 6 people at the time of the inspection. The service can support up to 8 people.
People’s experience of using this service and what we found
Right Support: People were not supported to have maximum choice and control of their lives. 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. The provider was not able to demonstrate how they were meeting the underpinning principles of right support, right care right culture. The service was not maximising people's choices, control or independence.
Right Care: People were not always supported to make meaningful choices. There was a lack of person-centred care and people's human rights were not always upheld. People were not supported to lead inclusive and empowered lives. People had care plans in place. However, these were not always written in a way that was person centred and easy to understand; we found inconsistencies in care plans, a lack of detail and care plans which had not been updated to reflect the current support people were receiving. People were at increased risk of not being supported in the least restrictive way possible and in their best interests.
Right Culture: The service was not well led. The quality assurance systems to assess and monitor the service were not always in place, and where they were, they were not effective. We found the provider did not have enough oversight of the service to ensure it was being managed safely and quality maintained. Quality assurance processes had not identified all of the concerns in the service. Records were not always complete. Indicators of a closed culture were identified, and staff morale was low. Staff did not feel confident in raising concerns with the provider. This meant people did not always receive high quality care. We have made a recommendation related to safeguarding.
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 the service was good (published on 30 May 2019).
Why we inspected
The inspection was prompted in part due to concerns received about governance and concerns shared by the local authority relating to care planning, risk management, staffing and medicines. A decision was made for us to inspect and examine those risks.
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 The Firefly Club on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to staffing, person-centred care, safe care and treatment, premises and equipment, assessing and monitoring risk and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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 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.