18 February 2020
During a routine inspection
At the time of this inspection there were three people accessing the respite unit, some on a longer-term basis until a more suitable placement could be sourced. Thirteen people were being supported in five bungalows. A bungalow empty at the last inspection was now refurbished. Two people previously living in the respite unit had moved into this bungalow as planned.
The service has been designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The service did not always consistently apply these principles and values. Staffing levels meant people could not always participate in activities they enjoyed doing on occasions.
People’s experience of using this service and what we found
Premises checks were in place to ensure that all the accommodation was safely maintained, although not all aspects of electrical installation had been completed to ensure compliance. All necessary work was completed shortly after this inspection. There were sufficient numbers of staff providing support to people. In times of emergency staff from the respite unit had supported people living in the bungalows. This had impacted on people’s support. Recruitment processes helped ensure staff employed were suitable for their job role. People were offered and received their medicines as prescribed; staff had been trained and had their competency checked to administer medicines safely. The service had learned lessons following the outcome from a safeguarding investigation and delivered additional medicines training to night staff. Systems were in place to help ensure people were protected from the risks of abuse and avoidable harm.
Staff had received training in aspects of care relevant to people's needs and now received regular supervision. People received sufficient nutrition and fluids, including any modified or specific diets. People accessed appropriate healthcare services when required and were able to live healthier lives. 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. Where the provider deemed the service no longer best met people’s increased needs, referrals for reassessments were sent to the local authority.
Steps had been taken to ensure people's rights were understood and respected. People were assured they would receive care that was not discriminatory. Staff respected people's privacy and dignity and encouraged people to be as independent as possible. People’s views and preferences were reflected in their support plans. People were cared for by friendly staff.
People received personalised and responsive care. People were supported to achieve their goals and pursue activities that supported their independence. The registered manager was aiming to encourage people to try new things and use local public transport more. Communication needs were assessed, although specific communication needs were not always fully supported. We have made a recommendation about addressing this. Processes were in place and followed to ensure any complaints received were investigated and resolved.
The systems the provider had introduced since our last inspection had helped to shape and improve the service, but these were not fully effective and needed to be properly embedded by the registered manager. The registered manager was supported by a wider management team. Staff felt supported and considered the service had improved. The service worked in partnership with numerous external stakeholders, and shared information appropriately where required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The provider completed an action plan after the last inspection to show what they would do and by when to improve and we identified one breach in regulation. At this inspection we found the service had improved and the provider was no longer in breach of regulations.
The last rating for this service was requires improvement (published 20 February 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections whilst managed by this provider.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. 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.