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
Peter House is a small residential care home for people who have a learning disability, autistic people and people who may also have a mental illness. At the time of the inspection, seven people were being supported, six of who were receiving the regulated activity of personal care. The service can support up to nine people.
This is the first inspection of the service under a new provider, however senior leaders at the service remain unchanged.
People’s experience of using this service and what we found
The service was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right support
The physical environment in communal areas had been updated but lacked a homely feel. The service was working in making these areas more engaging and comfortable. Peoples personal spaces did reflect their individuality. Outside areas continued to be unsafe and inaccessible for people with mobility issues. This had not been addressed following concerns at the last two inspections.
Although some key events and opportunities for people were taking place, people did not always have access to daily meaningful and engaging activity. The registered manager told us the service had gone some time without an activity member of staff and new activity member of staff was employed during the inspection. Their role would be to review that activities that people were offered and ensure that these reflected individual goals and were person centred.
Peter House is rural in location and to access the community required access to transport. At the last inspection there had been a lack of staff able to use the services transport. We found this had improved.
Right care
Peoples care plans although person centred, were significantly out of date. More work was needed to ensure cares plans continued to meet people’s current needs. However, staff knew people very well and were usually responsive to people’s needs.
People were supported to become as independent as they could be and were supported to have choice and control over their support they received.
Right culture
The registered manager had been in post for six months and had a strong vision of the quality of care people should achieve, based upon empowerment and inclusivity. With a newly appointed deputy manager, work was in progress to make the changes needed to ensure that people could live well every day.
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 the service under the previous provider was requires improvement, with a rating of inadequate in the well led domain (published 18 September 2019).
The service remains rated requires improvement with an improved rating for the well led domain. This service has been rated requires improvement for the last five consecutive inspections.
Why we inspected
This inspection was prompted by a review of the information we held about this service and to assess that the service is applying the principles of Right support right care right culture.
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.
We have found evidence that the provider needs to make improvements. Please see effective, responsive 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. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Peter House on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 have identified breaches in relation safe care and treatment, person centred care and the service being well led by the provider 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 request an action plan from 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.