Archived: 186-188 Lowdell Close

Updated 12 September 2020

The inspection

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notices we previously served in relation to Regulations 9 (Person-centred care), 17 (Good governance) and 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. It was also carried out to check if the provider had met regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities), which they were also breaching at our last inspection. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

Inspection team

This inspection was undertaken by one inspector on 12 August 2020.

Service and service type

186-188 Lowdell Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they 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 unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. This included the action plan the provider sent to us following the last inspection saying what they would do and by when to improve. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. 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. We had also requested information from the provider prior to the inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and the provider’s director. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at the care plans for two people, medicines support records and a variety of records relating to the management of the service.

After the inspection

We spoke with two relatives, one member of staff and one adult social care professional who has worked with the service. We continued to seek clarification from the provider to validate evidence found.

Updated 12 September 2020

About the service

Life Opportunities Trust - 186-188 Lowdell Close is a care home providing personal care for up to four adults with learning and physical disabilities. Four people were using the service at the time of the inspection.

Services for people with learning disabilities and/or autism should be developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The principles and values are to ensure people who use the service can live as full a life as possible and achieve the best possible outcomes. They reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the services should 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

Relatives of people using the service told us, “Generally, it’s not a bad home but it’s not the same as it was.” Relatives said the quality of the service had declined since the last inspection. They felt this was because of staffing issues and people not being supported to go out and about very much.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support. This is because people were not treated with dignity and respect at all times. There had been some improvements in supporting people to participate in activities, but some people were not always supported to help them experience good, meaningful everyday lives. This was in part because the provider had not consistently deployed enough sufficiently trained and competent staff to meet people’s needs effectively at all times.

The service did not have robust arrangements to ensure people always received positive behaviour support in line with good practice guidance. Staff were caring with people but did not always promote good communication with them.

The provider engaged temporary agency staff to cover support worker vacancies. They arranged for the same agency staff to attend so people could be supported by people they were familiar with. Medicines were not always managed appropriately and incidents and accidents were not recorded consistently, which could put people at risk of poor care.

The provider's systems for identifying, assessing and mitigating risks to people’s well-being and the quality of the service had not always been operated effectively.

People were not always supported to have maximum choice and control of their lives. However, staff did support them in the least restrictive ways possible and in their best interests. Policies and systems in the service promoted such practice.

There were systems to safeguard people from the risk of abuse and to prevent and control infection. There were fire safety arrangements in place.

The provider operated suitable recruitment procedures designed to ensure only 'fit and proper' staff were employed at the home.

The provider had improved the home environment by ensuring mobility and bathing equipment had been repaired, decorating some areas and ensuring the garden was more accessible to people.

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 5 June 2019).

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 or sustained and the provider was still in breach of regulations. The service remains rated requires improvement.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to person-centred care, staffing, safe care and treatment 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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.