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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. This service was meeting some of these underpinning principles.About the service
Broom Lodge is a care home which can provide personal care for up to six people with learning disabilities or autistic people. At the time of this inspection there were four people living at the service.
People’s experience of using this service and what we found
Staff aimed to support people to have maximum choice and control of their lives. Staff were not always able to support people in the least restrictive way possible. Mental capacity assessments were not always decision specific and lacked detail about how a person’s capacity had been assessed.
The provider has put a quality assurance system in place. The area manager and registered manager completed regular audits of the service and when they identified issues put action plans in place. We found the governance arrangements did not always identify gaps in practice.
Not all staff working at the service had completed or updated their mandatory training. People’s care and support plans sometimes contained conflicting information and following feedback the registered manager made improvements to their record keeping regarding visits from healthcare professionals.
Information about risks to people sometimes lacked detail and people’s care records were not routinely provided in an accessible format.
The registered manager used a dependency tool to calculate the number of staff needed and there were enough staff on duty to support people. Staff supported people to pick their meals and made sure they had enough to eat. Staff provided opportunities for people to engage in meaningful activity and access the community. Medication storage, handling and administration were generally effective.
We observed staff deliver care and support in a kind and compassionate manner. Staff were dedicated and committed to providing an effective service. Relatives found staff were fantastic and created a warm and friendly environment.
Staff adhered to COVID-19 guidance on working in a care setting.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 1 April 2021 and this is the first inspection.
Why we inspected
In September 2021 we completed a direct monitoring activity, which involved gathering feedback from staff, relatives and people who use the service as well as looking at a wide range of documents. This identified some areas of practice, which were potentially of concern and this triggered the inspection. These were particularly around supporting people to manage their emotions and consistency of care.
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.
We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment, and good governance.
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 from 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.