Background to this inspection
Updated
30 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 24 July 2018 and was unannounced. The inspection was carried out by two inspectors.
Prior to our inspection, we reviewed information we held about the service, including previous reports and notifications sent to us at the Care Quality Commission. A notification is information about important events which the service is required to send us by law. The inspection was informed by feedback from professionals which included the commissioning team that had placed people with the service, and the healthcare professionals. We looked at the information sent to us by the provider in the Provider Information Return. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection, we met all four people living at the home. We spent time observing interactions between people and the staff who were supporting them. We spoke with one person who used the service, the registered manager, the service manager, the deputy manager and two care staff. We reviewed two people's care plans and risk assessments, three people’s daily care records, and all four people’s medicines administration records. We looked at staff rotas and four staff files including their recruitment, training, supervision and appraisal records. We looked at accidents, complaints and safeguarding records, staff team meeting minutes, people’s engagement session records, quality audits and health and safety, maintenance and monitoring checks.
Following the inspection, we spoke with one relative, a healthcare professional and spoke again with one of the commissioning bodies. We reviewed the documents that were provided by the service on our request after the inspection.
Updated
30 August 2018
This inspection took place on 24 July 2018 and was unannounced. The service was last inspected on 22 and 28 November 2017, where we found the provider to be in breach of six regulations in relation to person-centred care, dignity and respect, safe care and treatment, premises and equipment, staffing and good governance. The service was rated Inadequate and was placed in ‘special measures’. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve all five key questions to at least good. At the inspection on 24 July 2018, we found the provider had made improvements but remains Requires Improvement. This is the fourth consecutive time the service has been rated Requires Improvement.
The Hoffmann Foundation for Autism – 4 Park Avenue is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection
The Hoffmann Foundation for Autism – 4 Park Avenue is a residential care home registered to provide accommodation and personal care support for up to six people who have learning disabilities and may have autism, Asperger's Syndrome or display characteristics that fall within the autistic spectrum disorder. At the time of our inspection, four people were living at the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Risks to people were identified, assessed and mitigated. Staff were trained in safeguarding and whistleblowing. They were knowledgeable in how to safeguard people against avoidable harm and abuse. Accidents and incidents were recorded and reported. There were processes in place to share with the staff team lessons learnt from the incidents to minimise reoccurrence. People were safely supported with their medicine management needs. The provider followed safe recruitment procedures and there were sufficient numbers of staff to meet people’s needs safely. Premises were renovated and bathrooms and toilets were fixed. A new cleaner had been appointed and the service was clean and without malodour.
People’s needs were assessed and staff knew people’s needs and abilities. Healthcare professionals were consulted in relation to people’s nutrition and hydration needs. However, their recommendations were not always appropriately followed. People were offered different types of food and staff promoted a nutritionally balanced diet. Staff gave people choices and supported them with making decisions.
Staff were trained in equality and diversity, and dignity in care. We observed caring interactions between people and staff, and saw people were treated with dignity and respect. People were encouraged to carry out daily living tasks to maintain their independence. People’s cultural and religious needs were identified and met.
People’s care plans were personalised and reviewed. Staff knew people’s likes and dislikes. People were supported to participate in activities as per their hobbies and interests. The service encouraged relatives and people to raise concerns and make complaints. The complaints procedure and response letter needed to be updated to be in line with the provider’s complaints policy.
The provider had introduced new systems and processes to assess, monitor, evaluate and improve the service delivery. However, the audits had not identified some gaps that were picked up during this inspection. Staff felt well supported by the management and told us there had been lots of new improvements since the last inspection. The management had introduced new ways to engage with people to seek their feedback on improving the care delivery. Staff’s views and ideas were considered to improve the service.