Archived: Michael Batt Foundation

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.

46 Grenville Road provides care and accommodation for up to three people with learning disabilities. On the days of our inspection there were two people living at the care home. Each person had their own living area.

There was a 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. At the last inspection on the 8 October 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated good:

We met and spoke to both people during our visit and observed the interaction between them and the staff. People were not able to fully verbalise their views and used other methods of communication, for example electronic tablets and symbols.

People were asked if they felt safe. One person said; “Yes, because I’m happy.” Staff said; “People are safe because there is always enough staff and staff know people well.”

People remained safe at the service. People had one to one staffing at all times. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. Staff confirmed there was sufficient numbers of staff to meet people’s needs and support them with activities and trips out.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible. People received their medicines safely by suitably trained staff.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff had completed safeguarding training. Staff had also completed the Care Certificate (a nationally recognised training course for staff new to care). Staff said the Care Certificate training looked at and discussed the Equality and Diversity policy of the company.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s end of life wishes were not currently documented, however the provider had arranged end of life training for staff. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.

People’s care and support was based on legislation and best practice guidelines, helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people preferences and wishes. Information held included people’s previous history and any cultural, religious and spiritual needs.

People were treated with kindness and compassion by the staff who valued them. The staff had built strong relationships with people. People's privacy was respected. People or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People had complex communication needs and these were individually assessed and met. People were able to make choices about their day to day lives. The provider had a complaints policy in place and the registered manager confirmed any complaints received would be fully investigated and responded to.

The service continued to be well led. People lived in a service where the registered manager’s values and vision were embedded into the service, staff and culture. Staff told us the registered manager was approachable.

The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the registered manager and provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.

However, not all audits were documented to show areas requiring maintenance and updating. Though people were protected from the spread of infections the kitchen environment required work to ensure people were protected from any health risk. The registered manager told us they would ensure this was done.

We spent time in the communal parts of the home speaking to staff and observing the care being provided. We observed that staff had a good understanding of people's needs and had formed positive relationships with the people they supported.

Records and discussion with staff confirmed that people's rights and ability to consent was considered when planning and providing care and support. Correct procedures were followed to protect people's rights when they were unable to consent and make choices about their care and lifestyle.

The support plans we looked at provided staff with clear and up to date information about people's needs and how they should be met. The staff we spoke to had a good understanding of this information and were able to tell us in detail about how people who used the service needed and preferred to be supported.

We found that the environment was clean and well maintained throughout.

Systems were in place to ensure that medication was stored and administered in a way that was appropriate and safe.

Records relating to people using the service were well organised and safely stored.

We spoke to one person who lived in the home. They told us about their plans for the day and was very excited about planning a birthday celebration. All of the people we met appeared relaxed, happy and contented within their home.

People were kept well informed of any changes to the services and information was provided in a way that people could access and understand.

We saw staff treating people in a dignified and respectful manner. Staff told people what they were doing as they provided support and also encouraged people to be independent whenever possible.

People were able to access a range of health care services and specialist advice was sought when needed.

Staff were aware of issues relating to abuse and were aware of what they needed to do to keep people safe.

We spoke to staff during our inspection. One staff member had only worked in the home a short time, but had a good understanding of people's needs and the running of the home. They said that they had had a thorough induction, which had given them the opportunity to work alongside other staff members as well as read documents relating to the service and people's care arrangements.

Systems were in place to regularly review the quality of the service, and changes had been made when improvements were identified.