Archived: Rockville Short Break

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.

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

Right Support

People's needs were met by suitable numbers of staff who knew them well. People brought their medicines in with them when they started their stay and staff supported them to take their medicines safely. People were protected from the risk of infection. People received the necessary nutritional support and meals were tailored to individual preferences. People’s independence was promoted. 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 care and support from skilled and knowledgeable staff. People’s care records reflected their individual needs and how to promote their well-being whilst providing care and support. People received personalised care which was responsive to their individual needs.

People were protected from poor care and abuse by staff who understood how to protect people from harm. People took part in a variety of activities that interested them.

Right Culture

People were supported to live as full a life as possible and achieve the best possible outcomes, that included choice, control and independence. People received kind and considerate care from staff who promoted and respected people’s dignity and privacy. Staff understood people’s varying needs and responded accordingly. The provider had a complaints procedure in place. The registered manager and deputy manager sought and listened to relatives and staff views and action was taken where required. This promoted an open, inclusive and empowering culture.

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 10 December 2021).

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.

At our last inspection we recommended the provider reviewed the service in line with best practice guidance such as Right support, right care, right culture. We also recommended the provider sought advice and guidance about identifying and developing people’s goals and aspirations. At this inspection we found the provider had acted on recommendations and made improvements.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 27 September 2021. Breaches of legal requirements were found. The provider completed an action plan after the inspection to show what they would do and by when to improve safeguarding service users from abuse and improper treatment and good governance.

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.

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

Follow up

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

Rockville Short Break is a respite service providing personal care for up to two adults under the age of 65 years at a time who had a learning disability and/or autism. The service provides short respite breaks for people in a semi-detached house over two floors with a passenger lift between floors. At the time of the inspection, there were six people who regularly used the service, two at a time.

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

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.

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.

Right support:

• The model of care and setting did not maximise people’s choice, control and independence. People’s records and the care they received were not focused on people’s strengths. There was insufficient evidence to show people had a fulfilling and meaningful experience at the service which was based on their aspirations and goals; or that staff understood how to support people to achieve these.

• Systems in the service had not identified all restrictive practices.

Right care:

• Care was not always person-centred and did not always promote people’s human rights. At times people who used wheelchairs received less support because they could not move independently and therefore the risk of leaving them alone was lower. Most people were unable to communicate verbally. Staff told us they understood how people communicated, but there was limited information recorded to help ensure staff had a consistent and detailed understanding. The registered manager told us they were in the process of implementing this information.

Right culture:

• The systems in the service had not ensured that the provider’s ethos and values were embedded in the service, enabling people to lead confident, inclusive and empowered lives. Audits and checks of the service had been completed but had not found or prioritised all the areas for improvement identified during the inspection.

The service did not have enough staff to ensure all people still received one to one support when others needed two staff to provide personal care. This meant some people had unnecessary restrictions placed on them. People were not always supported to have maximum choice and control of their lives and staff could not always support them in the least restrictive way possible and in their best interests. Assessments of people's capacity to make decisions had been made, but not all decisions had been made in people’s best interests.

Staff understood risks to people, but these were not all recorded in sufficient detail. Action had not always been taken when health and safety checks identified a problem with fridge and water temperatures.

Staff recruitment checks were in place, but these did not always record staff’s full employment history.

Staff had been trained in how to administer medicines to people but the quantity of different medicines entering and leaving the service with people was not recorded.

Staff received appropriate training and support to enable them to carry out their role safely. Staff also received checks of their competence and told us they were confident and well supported in their roles.

People’s health was monitored, and any concerns shared with relatives. Any changes to the support they required with their health were recorded and shared with staff. The service worked closely with other professionals to help ensure people’s health care needs were met.

Systems and checks were in place to ensure people were protected from the risk of infection.

Staff described the manager as supportive and responsive to any ideas or concerns. Relatives told us they found the registered manager and staff to be open and honest.

The registered manager was committed to improving the service and responsive to the feedback from the inspection.

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

Why we inspected

This service was registered with us on 30 July 2020 and this is the first 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 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.