Background to this inspection
Updated
23 September 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
Lataya House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
There was not a registered manager in post at the time of inspection. A manager was in post but not yet registered. This means only the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced; however, we spoke to the manager on the phone before entering the service. This supported the home and us to manage any potential risks associated with Covid-19.
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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and two relatives about their experience of the care provided. We observed staff supporting people who were unable to talk to us. We spoke with four members of staff including the manager and care workers.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision and nine agency staff records. A variety of records relating to the management of the service, including policies and procedures, were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with two professionals who regularly visit the service.
Updated
23 September 2020
About the service
Lataya House is a residential care home providing personal and nursing care to 4 younger adults with learning disability and autism at the time of the inspection. The service can support up to 6 people in one adapted building.
Lataya House is a family sized house in a residential area, similar in appearance to the other houses in the street. It is close to local amenities and affords easy access to the community.
People’s experience of using this service and what we found
Systems in place to monitor and improve the quality of the service were not robust. The provider had not previously identified the issues we found during inspection.
Restrictive intervention was carried out by staff who were not trained to do so. Records relating to incidents of behaviour which challenged, and staff response to this were disorganised and unclear. Opportunities for improvement were missed.
Staff did not act in accordance with risk assessments in relation to water temperature. Checks to ensure the environment was safe were not up to date.
The provider had failed to set out clear PPE guidance for staff in response to the risk of transmission of coronavirus.
The provider had been set an action plan by the local authority in February 2020, however we found ongoing issues during this inspection. Staff at the service worked well directly with health and social care professionals.
Appropriate recruitment checks took place before staff started work. Permanent staff received training to enable them to carry out their roles effectively. Staff were happy working for the service and felt supported by the provider and manager.
Relatives were happy with the care and support they received and spoke positively about staff. People's care and support needs were met by staff who knew them and enjoyed working with them.
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; however the policies and systems in the service did not always document this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 7 August 2019).
Why we inspected
We received concerns in relation to the use and recording of physical intervention. As a result, we undertook a focused inspection to review the key questions of Safe, Effective 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.
We have found evidence that the provider needs to make improvement. Please see the Safe, Effective 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 Lataya House 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 the use of physical intervention, environmental safety and good governance at this inspection.
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 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.