Archived: Hoffmann Foundation for Autism - 45a Langham Gardens

Updated 18 January 2020

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 Care Act 2014.

Inspection team

The inspection team consisted of one inspector and specialist advisor. The specialist advisor was a social worker who had experience of working with people with learning disabilities.

Service and service type

Hoffmann Foundation for Autism - 45a Langham Gardens 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. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service did not have a manager registered with the Care Quality Commission. At the time of this inspection we saw the current new manager had submitted application to CQC to be registered. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about this service, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the service. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also viewed the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well and improvements they plan to make. This information helps support our inspections. Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public and local authorities.

During the inspection

We were not able to speak with people because of their complex needs. We attempted to contact people's relatives and were able to speak with two relatives. We spoke with six members of staff including, the manager. We reviewed a range of records, including recruitment information and a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received information relating to the provider’s governance systems and some care records. This information was used as part of our inspection.

Updated 18 January 2020

Hoffmann Foundation for Autism - 45a Langham Gardens is a supported living service for people with a learning disability or autistic spectrum disorder. It provides personal care for people who live in their own accommodation. At the time of this inspection the service provided care for four people. The scheme covered a range of areas including prompting with medicines, personal care, weekly shopping, housework and laundry.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

We found action to address findings from our last inspection in July 2018 had not yet led to improvements in all areas. Behavioural support plans and care plans were still of inconsistent quality. The application of Mental Capacity Act was also still inconsistent. The service had recognised these shortfalls and were already acting. However, the pace of change had been slow.

Progress had been advanced over the past two months, under the leadership of a new manager. The manager and her team had started to review and make improvements to people’s care records. There were formal systems for auditing. All issues that were identified were then acted upon. However, evidence of effective and sustained systems for oversight need to be demonstrated. We will review this at our next inspection.

There were procedures for investigating and learning from accidents. However, learning was limited because incidents were analysed separately. We discussed with the manager the need to analyse incidents together in order to consider generic causes.

People were not effectively supported to have maximum choice and control of their lives. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act 2005 were not always followed. We made a recommendation for the provider to seek advice to maximise people's choice, control and independence regarding their money.

People were protected from the risk of harm and abuse. Safeguarding procedures were in place, which staff were aware of. Staff were recruited safely. Improvements had been made in risk management. Risks to people had been identified, assessed and reviewed. We also observed good practice in relation to the management of medicines, including storage, disposal and completion of medicine records.

People accessed healthcare and had their health needs met. There were systems and processes to support this. People’s care records showed relevant health and social care professionals were involved in their care.

People’s privacy and dignity were respected. Staff protected and respected people's human rights. They had received training in equality and diversity. People’s spiritual or cultural wishes were respected. Staff maintained people's independence by supporting them to manage as many aspects of their care as they could. People’s privacy was also upheld in the way their information was handled.

We observed a range of practices that reflected person centred care. People’s values and preferences were respected. Their families were involved in care as appropriate. People had access to appropriate care and information, which was presented in an accessible way for people to make decisions about their care.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 September 2018) and there were four breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough, improvement had not been made and the provider was still in breach of regulations.

The last rating for this service was requires improvement. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

Enforcement

We have identified a breach in relation to the application of the Mental Capacity Act 2005 and good governance.

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

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.