25 April 2023
During an inspection looking at part of the service
About the service
St Phillips Close is a residential care home and is registered to provide accommodation and personal care. The building is purpose built and provides facilities and living accommodation for up to 8 people who live with a learning disability and/or a physical disability. There are two separate buildings which accommodate 4 people in each.
People’s experience of using this service and what we found
Right Support:
People’s risk were assessed in a person centred way, however, these were not reviewed on a regular basis. Care planning did not routinely involve the person and their relatives as appropriate. People who may become anxious or distressed had positive behaviours support plans, however, these had not been reviewed for some time. People were generally encouraged to make choices and decisions in accordance with their level of understanding.
People had their own bedroom and shared facilities. Staff took action to ensure people’s care and support was in a safe, clean and well-maintained environment. However, staff told us concerns raised with the landlord and senior managers were not being addressed in a timely way.
People were 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 supported this practice.
Right Care:
Staff had completed necessary training to meet people’s needs. However, they did not always recognise risk of harm to people and did not always escalate concerns as required. During the inspection staff raised a whistle blowing concern, the provider began a process of investigation.
Right Culture:
The culture of the service supported people and staff in an inclusive way; enabling people to live their day to day lives as they chose to. Staff told us that the culture of the service had greatly improved as a new team had been formed. However, quality assurance systems to assess and monitor the service were not always being routinely used. This meant the provider did not have enough oversight of the service to ensure it was being managed safely and quality maintained. Therefore, we could not always be assured people always receive high quality care.
There were missed opportunities for staff to involve people in day to day activities such as cooking, cleaning, laundry. There were long periods of time when people were not spoken to, particularly people who did not seek staff attention. One person spent all day in bed due to not having appropriate equipment in place to enable them to access the rest of the house.
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 31 March 2020).
Why we inspected
We received concerns in relation to governance and risk management. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe and Well led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Philip’s Close on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment and good governance at this inspection. We have made recommendations about safe recruitment, medicines storage and ‘as needed’ medicines.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
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.