14 January 2022
During an inspection looking at part of the service
About the service
Stubblefields House is a residential care home providing personal care and accommodation for up to ten adults or older people with a learning disability and/or autistic spectrum disorder. There were ten people living at the service on the day of the inspection. The service was not supporting anybody in the community at the time of inspection.
People’s experience of using this service and what we found
Systems were not effective to assess, monitor and improve the quality and safety of the service. The lack of systems meant the provider had failed to identify and address the concerns we found at this inspection.
Measures were not in place to mitigate the risk of the spread of infection. The service was not always clean and tidy and some areas of the environment required improvement. The provider acted during the inspection to improve infection control measures.
People were at risk of avoidable harm because risks to people had not always been identified, assessed and mitigated.
There was insufficient staff deployed which impacted on the cleanliness of the service and people’s ability to access the community. The management team were consistently working on shift which impacted their abilities to carry out their roles. The provider was actively recruiting staff.
People did not always receive individualised care and were not always fully supported to continue their hobbies and interests during the pandemic.
People received their medicines as prescribed but best practice was not always followed. We have made a recommendation about this.
Recruitment procedures were in place, but these had not always been followed. We have made a recommendation about this.
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 and their relatives shared positive feedback about the service. We received positive feedback about the management team and staff felt supported. It was clear people had developed positive relationships with staff and the management team.
This service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. This included people’s environment been restricted due to been used as a staff sleep area and a office in a communal corridor. People had not been supported to maintain hobbies and interests during the pandemic. The provider told us they would be working with the local authority to review individuals needs and support.
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 of this service was good (published 10 January 2018)
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about visiting procedures. A decision was made for us to inspect and examine those risks.
We inspected and found there were concerns with infection control, person centred care and governance, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, responsive and well-led.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion 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 looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 monitor the service 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 risk management, infection control, person centred care and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.