29 November 2023
During an inspection looking at part of the service
The Grange is a residential care home providing personal care and accommodation to up to 9 people. The service provides support to people with a learning disability and/or autism. At the time of our inspection there were 7 people using the service.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: Safeguarding procedures had not been fully established. Support plans and risk assessments did not always include information to guide staff on how to provide care and support which was meaningful for the individual. This placed people at risk of not having their needs met.
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.
Right Care: Care plans did not contain sufficient information to ensure people's needs, goals and wishes were met.
Right Culture: The culture of the service was reflective of an older person’s service rather than the support required by people with a learning disability autism or both.
The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support. This had led to shortfalls found during the inspection.
We received positive feedback from relatives regarding the care and support provided.
The manager and quality manager were open and honest about the shortfalls at the service. They engaged with the inspection positively and demonstrated a commitment to making any necessary improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 26 March 2019)
Why we inspected
This inspection was prompted by a review of the information we held about this service and concerns we had received about the hours staff were working. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. 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.
Enforcement and Recommendations
We have identified breaches in relation to safeguarding procedures, compliance with the Mental Capacity Act, person centred care and the overall governance of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
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, which will help inform when we next inspect.