St Anne's Community Services - Smithies Moor Lane

Updated 12 January 2024

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.

Inspection team

The inspection team consisted of 2 inspectors, a regulatory co-ordinator, an Expert by Experience and a medicines specialist advisor. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St Anne's Community Services - Smithies Moor Lane is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Anne's Community Services - Smithies Moor Lane is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England We used the information the provider sent us in the provider information return (PIR). 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 used all this information to plan our inspection.

During the inspection

We spent time in communal areas observing the care and support provided by staff to help us understand the experience of people who could not talk with us. We spoke with 4 relatives and 8 staff, including support workers, the registered manager and area manager.

We reviewed a range of records. This included 3 people's care records and 4 people’s medicines records. We reviewed 2 staff recruitment files and a variety of records relating to the management of the service.

Updated 12 January 2024

About the service

St Anne's Community Services - Smithies Moor Lane. Is a residential care home providing accommodation, and personal and nursing care to up to 6 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 5 people using the service.

People’s experience of the 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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Care:

The service did not have effective systems to show care was person-centred care. People did not have plans to set out their day or week and there was no record to show how people's days should unfold, which meant staff decided what people should do. People did not have assessments and plans to ensure they were offered opportunities to achieve goals, learning, and new experiences.

People were not supported to follow their interests or take part in activities that were relevant to them. People did not have regular contact with the community and activities within the home were limited.

There were sufficient numbers of staff to keep people safe but the provider did not have effective systems for ensuring they had the enough staff to deliver high quality care. Care staff were observed cleaning the home and cooking meals so had less time directly supporting people.

We observed many positive interactions between staff and people who used the service. Staff knew people well and were kind and caring. For example, we saw staff supporting people to eat with care and dignity. People’s support plans guided staff around how to deliver individual care tasks such as eating, continence and mobility in a person-centred way.

The service worked effectively with external stakeholders and other professionals.

Right Support:

The service did not manage several areas of risk and quality well. For example, the service had a minibus which was funded by 4 people. However, the minibus was used infrequently. The provider was aware of the issue but had not addressed this. CQC shared these concerns with the local safeguarding authority.

People were not supported to receive their medicines in a safe way and risks to people were not always well managed.

People were usually 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 usually supported this practice.

Right Culture:

The service had an action plan but this did not identify shortfalls that we highlighted at the inspection, which meant actions to drive improvement were absent. Many issues were not included such as the lack of community access, unsafe management of medicines, failure to assess some risks to individuals, inconsistencies in incident recording and reporting, and failure to monitor decision making processes.

Feedback about the registered manager was positive. Relatives and staff shared examples where they felt improvements had been made, such as communication and views. Staff felt well supported in their role.

The management team were responsive to the inspection findings and shared information to show they were making improvements. However, we did not receive complete assurance from the provider that the issues relating to the minibus would be fully addressed.

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 Good (published 20 September 2018).

Why we inspected

We inspected due to the length of time since the last inspection.

We undertook a focused inspection to review the key questions of safe and well-led only.

During the inspection we found there was a concern with supporting people to follow interests and to take part in activities that are socially and culturally relevant to them so we widened the scope of the inspection to include the key question of responsive.

For those key question 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 St Anne's Community Services - Smithies Moor Lane on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to management of medicines and risks to individuals, person-centred care and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow Up

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

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