Parkhill Support Services Main Road

Updated 1 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in a 'supported living' setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of this inspection, there was no registered manager in post since July 2021. The current manager applied to be registered with CQC but withdrew their application during the interview process.

Notice of inspection

This inspection was unannounced. Inspection activity started on 28 April 2022 and ended on 8 June 2022. We visited the office location on 28 April 2022 and 18 May 2022.

What we did before inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we held about the service since they registered with us. We sought feedback from health and social care professionals and the local authorities that commissioned the service. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and two relatives on the telephone about their experience of the care provided. We spoke with six members of staff including the manager, an operations and business development manager, a quality manager, two support workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included two people’s care records and medication records. We looked at supervision records for three staff. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at a recruitment checklist, records of Disclosure and Barring Service (DBS) checks carried out for three staff and a complaint log.

Updated 1 July 2022

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

Parkhill Support Services Main Road is a supported living service providing personal care for up to six people with a learning disability and autistic people,, brain injury and complex health needs. At the time of our inspection there were two people using the service.

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

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right Support, Right Care, Right Culture.

Right 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. Care and support was not tailored to meet individual needs and to ensure people were supported to have a meaningful and fulfilling life and achieve best outcomes. People and their relatives were not always involved and encouraged to make decisions about the care and support in place or how the service was run. The service did not always work within the principles of the Equality Act by ensuring people’s diverse and cultural needs were met.

Right Care

Medicines were not safely managed to ensure they were effective when administered and achieved best possible health outcomes. The service did not always ensure that risks faced by people had been identified, assessed and planned for. Staff did not always understand the need to protect people in their care from abuse. Needs assessments were completed but they did not consider the ability of staff having the appropriate knowledge and skills to safely support people.

Right culture

The provider did not have oversight of the service. An effective quality assurance system was not in place. The culture at the service was not always positive. The service did not work effectively with other agencies to drive improvement. Lessons were not learnt from accident and incidents and safeguarding to drive improvement. There was an organisational structure in place, but staff did not always know of their individual roles and responsibilities.

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 20/03/2020 and this is the first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to regulation 9 (Person centred care), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), and Regulation 17 (Good governance).

We have made recommendations about staff recruitment records, infection prevention and control, staff support and access to healthcare services.,.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.