Sheringham House

Sheringham House is a care home registered to provide accommodation and support with personal care for up to five people with mental health needs, learning disabilities and autistic people. At the time of the inspection, one person was living at the home. The home has adapted facilities and en suite rooms.

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

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right support, Right care, Right culture, as it is registered as a specialist service for this population group.

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

Right support:

People had control of how their care and support was arranged. People were supported to integrate into the local community and be as independent as possible. They were supported to achieve positive outcomes and one person had recently secured a move to more independent accommodation. They were unable to speak with us because they were in the process of moving.

Right care:

Staff ensured people's dignity, privacy and human rights were respected. People received care and support that was personalised for their needs.

Right culture:

The values and attitudes of staff and managers in the home enabled people to be as independent as possible and feel empowered in their daily lives.

The provider had carried out improvements to the premises following our previous inspection, to ensure the home was safe and secure. Systems were in place to protect people from the risk of abuse. Risks to people’s health were assessed so staff could support them safely. Medicines were administered safely to people. Processes to assess people’s needs to determine the home was suitable for them were more robust.

The provider recruited staff appropriately and checked they were suitable to work with people. There were enough staff working in the home to support people. Systems were in place to prevent and control infections. Lessons were learned following accidents and incidents in the home.

Staff were trained to carry out their roles and received support with their continuous development. People were supported to maintain a balanced diet and their nutritional needs were monitored. People were supported to attend health appointments with professionals to help maintain their health.

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 pursued their interests and were supported to avoid social isolation. Systems were in place to manage complaints. People’s communication needs were met. Feedback was sought from people to help make continuous improvements to the home.

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 Requires Improvement (published 4 August 2021) and there were breaches of regulation. We issued Warning Notices to the provider for breaches of Regulation 15 (Premises and equipment), Regulation 9 (Person-centred care) and Regulation 17 (Good governance). A requirement notice was issued for breach of Regulation 10 (Dignity and respect).

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.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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.

Follow up

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

Sheringham House is a residential care home, providing personal care to people aged 16-19 years, with learning disabilities, autism and/or mental health needs. The home can support up to five people in one adapted building. At the time of the inspection, two people were using the service and one person was in hospital.

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

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 home was not a safe environment because there were shortfalls in the management of the service to assess, monitor and mitigate risks to people.

The provider was not ensuring the premises was a safe and secure place for people they supported and staff they employed. Locks on both the front porch door and back doors had been broken for more than a month. The fire alarm system had been faulty for nearly three months just prior to our inspection. The provider had failed to respond urgently to ensure these repairs were carried out. This meant people and staff were at risk of harm or injury because there was a lack of sufficient security to ensure their safety.

People’s privacy and dignity was not being respected at all times. People were not always assessed appropriately prior to them receiving support from the service to ensure their needs could be met. The culture and ethos of the service to provide person-centred care was affected because of this and people were not living fully empowered and independent lives.

People were supported with their medicines but we have made a recommendation around maintaining the temperature of the medicine storage room within a suitable range. Staff followed infection control procedures. However, we could not be assured all infection control risks to people were being mitigated against due to the security issues in the home, which could expose people to the risk of infection.

Incidents and accidents in the service were reviewed and analysed to prevent reoccurrence. There were suitable numbers of staff in the service and they were recruited safely. Staff told us they were supported by the manager and they received supervision to discuss their performance and any concerns they had. Staff received training to ensure they had the right skills to support people whose behaviour could challenge.

People maintained their health and nutrition with food and drink of their choice. Their communication needs were assessed. They were supported to follow their interests and maintain relationships. There was a complaints procedure for people to use. There were systems to obtain people's and relative’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 20 May 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the premises, the environment and the overall safety of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring 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.

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

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

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.