The Care Quality Commission
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Archived: Real Life Options - 120 Lichfield Road

Overall: Requires improvement read more about inspection ratings

120 Lichfield Road, Sutton Coldfield, West Midlands, B74 2TA (0121) 308 6963

Provided and run by:
Real Life Options

All Inspections

21 January 2016

During a routine inspection

This inspection took place on 21 January 2016 and was unannounced.

At the last comprehensive inspection in September 2015, this provider was placed into special measures by the Care Quality Commission (CQC). Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do meet legal requirements in relation to breaches of regulations. We undertook this full comprehensive inspection to check they had followed their plan and to confirm they now met legal requirements. This inspection found there were enough improvements to take the provider out of special measures. The provider now met their legal requirements but further improvement was required.

Lichfield Road is a residential home, where care and support is provided to five people who have learning disabilities or have mental health support needs. There were four people living in the home at the time of the inspection.

The accommodation was provided in single bedrooms; the home had bedrooms and bathrooms on the ground and first floor. There were shared lounges and dining facilities available on the ground floor.

At the time of this inspection there was no registered manager in post. 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. A manager had been appointed to run the home and was in the process of applying to become the registered manager. However they were not able to work at the home on a full time basis as they also had responsibility to manage another location which was located several miles away. They were not available during the inspection visit as they were on a training day.

One person told us they were happy at the home but other people were unable to verbally share their views about their experience living in the home.

Our inspection identified that changes and improvements had occurred across the service. Hazardous substances that may pose a risk to people were now kept securely. A person who required the use of a hoist to move was supported by staff to do this in a safe way. Arrangements had improved to make sure staff responded appropriately in the event of a fire occurring at the home and infection control procedures had been improved. The actions taken had reduced some of the risks to people’s safety but additional safety measures were needed in regards to the risk of a person falling out of bed. We were sent evidence of action being taken immediately following our visit.

Safeguarding procedures were available in the home and staff we spoke with knew to report any allegation or suspicion of abuse.

Previously there was not enough staff to meet personal care needs of people in a timely manner or to accompany people to go out of the home should they have chosen to go out at the same time, this restricted people’s choices. Changes to how staff were deployed and a recent reduction in the numbers of people living at the home had meant that staff were better able to support people.

People received the correct medication at the correct times. All medication was administered by staff that were trained to do so but some minor improvement was needed to ensure medication was administered and recorded in a safe way.

People were supported to maintain good health and to access appropriate support from health professionals where needed. Development was needed of the systems in place to promote good continence care and to make sure people were a healthy weight. People were supported to eat meals which they enjoyed and which met their needs in terms of nutrition and consistency.

We observed some caring staff practice, and staff we spoke with demonstrated a positive regard for the people they were supporting. We saw staff treating people with respect and communicated well with people who did not use verbal communication.

New staff were provided with an induction that would ensure they knew how to care for people and would ensure they could work safely. Training and supervision arrangements for staff had improved and further training for staff was scheduled.

There was a complaints procedure which was on display and was available in an easy to read version with pictures. Records to evidence the action taken in response to complaints being received had been completed but needed improvement.

Changes had taken place in the management staff team, in addition to the manager there was a team co-ordinator in post and both were now being supported by a newly recruited area manager. Whilst we received positive feedback from staff about the manager they were only able to spend limited time at Lichfield Road as they were also responsible for managing another care home. Arrangements for checking the safety and quality of the service had improved since our last inspection but further improvement was needed to ensure people were provided with a good service.

3 September 2015

During a routine inspection

This inspection took place on 3 September 2015. The inspection was unannounced.

Lichfield Road is a residential home, where care and support is provided to five people who have learning disabilities or have mental health support needs. There were five people living in the home at the time of the inspection.

The accommodation was provided in single bedrooms; the home had bedrooms and bathrooms on the ground and first floor. There were shared lounges and dining facilities available on the ground floor.

At the time of this inspection there was no registered manager in post. 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. A newly recruited manager was present during part of our inspection.

People living at Lichfield Road could not be confident that the registered provider would be able to keep them safe. This included the arrangements to make sure staff responded appropriately in the event of a fire occurring at the home. People were placed at the risk of infection from poor management arrangement of clinical waste and were not fully protected as we saw unclean bathroom and shower facilities.

There were not enough staff to meet personal care needs of people in a timely manner or to accompany people to go out of the home should they have chosen to go out at the same time, this restricted people’s choices.

One person told us they were happy at the home but other people were unable to verbally share their views about their experience living in the home.

We saw some undignified and uncompassionate practice, and staff we spoke with did not demonstrate a positive regard for the people they were supporting. We saw staff treating people with limited respect and did not communicate well with people who did not use verbal communication. We saw examples of staff not following the instructions in people’s care plans, for example during meals, and this placed people at risk.

New staff had not all been provided with an induction that would ensure they knew how to care for people and would ensure they could work safely. Not all of the staff had been provided with all of the training they required or with regular supervision.

There was a complaints process; however the provider did not convey openness to receiving or acting on complaints. Whilst people did advise they would raise concerns with staff people did not know how to raise a formal complaint or did not know who they would contact. There were no records to evidence any complaints being received or acted on.

At the time of our inspection a new manager was new in post, and there were no other senior staff working at the home. It was not evident that the governance system (ways of checking the safety and quality of the service) in place in the home or operated by the registered provider had been effective.

We found the provider was in breach of Regulations. You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

23 May 2013

During a routine inspection

During our inspection we spoke with one person that lived at the home, the manager and three members of staff.

One person living at the home told us, 'Staff ask me if I want to go out and I say yes.' We found that, before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People seemed happy living at the home. One person told us, 'I love it here it's fantastic, I have lived here a long time.' We found that people received care and treatment that met their needs and protected their rights.

We saw that people living at the home were able to choose what they wanted to eat and drink. One person told us that they were able to make their own breakfast and helped with preparing other meals. We found that people were protected from the risks of inadequate nutrition and dehydration.

We saw that the provider had a rigorous recruitment process in place to ensure that they employed the right staff to support people living at the home.

People told us that they had no concerns about living at the home and we saw that people were comfortable in their environment. We found that the provider had systems in place to monitor the quality of the service that people received.