Background to this inspection
Updated
14 February 2024
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Michael Batt is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Michael Batt is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with a director and the new manager and 2 care staff.
We reviewed a range of records. This included 2 people's care records We looked at 6 staff files in relation to recruitment. A variety of records relating to the management of the service, including medication records, accidents and incidents and training records. After the inspection We continued to seek clarification from the provider to validate evidence found.
Updated
14 February 2024
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Michael Batt Foundation is a residential care home that provides personal care and support for up to 3 people with a learning disability, autism or who have complex needs associated with their mental health. At the time of the inspection there were 2 people living at the service.
People’s experience of using this service and what we found
Right Support: The Model of Care and setting within the service did not maximise people’s choice, control and independence. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People were not protected from the risk of harm as systems and process did not provide staff with all the information needed to meet people's needs safely. There were insufficient arrangements in place to ensure people had access to appropriate space. The premises did not always meet people’s support needs.
Right Care: Risks such as those associated with people's complex health and / or medical needs were not adequately assessed by the provider. Staff did not have access to all the information they needed to meet people's needs safely.
People did not always have their human rights upheld, and the service did not always promote equality. Staff and people were subject to unsafe staffing arrangements.
Right Culture: Restrictive practices, poor application and understanding of the Mental Capacity (MCA), a lack of openness and transparency and inadequate governance and oversight had helped to create a 'closed culture' at The Michael Batt Foundation.
A 'closed culture' is a poor culture that can lead to harm, including human rights breaches such as abuse. In these services, people are more likely to be at risk of deliberate or unintentional harm. It was evident from a review of the data and information held by the provider, and our findings throughout our inspection that staff did not receive regular, effective supervision and support.
The provider was aware of their regulatory responsibilities such as submitting statutory notifications but failed to carry this out. The findings of our inspection identified a culture that was not based on learning. This meant that when things had gone wrong, the potential for re-occurrence was inevitable because there was no action taken to review, investigate and reflect on incidents.
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 4 January 2018)
Why we inspected
We undertook a focused inspection to review the key questions of safe and well-led only. However, further concerns and risks were identified so a decision was made to include the key question of effective.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Enforcement
We have identified breaches in relation to safe care and treatment, safeguarding people from abuse, consent, premises, person centred care, staffing, notifications of other incidents and governance.
Please see the action we have told the provider to take at the end of this report.
The overall rating for the service has changed from good to inadequate based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Michael Batt on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.