4 November 2020
During an inspection looking at part of the service
The Moors is a residential care home providing personal care to 5 younger adults with learning disability and autism at the time of the inspection. The service can support up to 5 people across two adapted buildings. 4 people live in the main house and 1 person lives in an annexe.
The Moors is a family sized house in a residential area, similar in appearance to the other houses in the street.
People’s experience of using this service and what we found
Medicines were not always safely managed. Best practice guidance was not always followed and when people received their medicines 'as and when required' (PRN) the correct PRN protocols were not in place.
Health and safety audits were not always completed in line with best practice guidance. Several health and safety tasks were not completed in line with the provider’s policies.
Personal Emergency Evacuation Plan (PEEP) information was not in place. This meant people were at risk of not being appropriately supported to evacuate the premises in the event of an emergency.
Food hygiene standards were not always sufficiently met. We found several out of date items of food in the fridge.
The provider failed to have enough staff with the right skills deployed to provide people with their commissioned care. This placed people at risk of harm.
The provider had quality control systems in place, however they were not always effective as records were not always correct and audits had not always identified errors in records.
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’s individual risks were managed in a safe way and staff knew how to protect people from the risk of harm and abuse. Risk assessments were completed appropriately, for example around nutrition, equipment, personal care and behaviour.
Lessons were learnt when things went wrong. The provider identified trends and themes when issues occurred and developed strategies to mitigate the risk to people.
Care records were person-centred and contained sufficient information about people’s preferences, specific routines, their life history and interests.
People and their representatives were involved in the planning of their care and given opportunities to feedback on the service they received. People’s views were acted upon.
The provider and management team had good links with the local communities within which people lived.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The model of care and setting maximises people’s choice, control and independence.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
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 15 January 2020).
Why we inspected
We received concerns in relation to staffing levels, staff training, medicines errors and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
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 The Moors on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to staffing, medicines, environment and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
The provider supplied us with an action plan to inform us of 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.