Background to this inspection
Updated
26 September 2023
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 Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by 2 inspectors.
Service and service type
Stoke View 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The first day of this inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We reviewed the information we held about the service, including notifications we had received. Notifications are changes, events, or incidents the provider is legally required to tell us about within required timescales. We sought feedback from the local authority. We used this information to plan the inspection.
During the inspection
We spent time with and spoke with 8 people living at the service, 3 members of staff, the registered manager and the owners of Stoke View. To help us assess and understand how people's care needs were being met, we reviewed 5 people's care records. We also reviewed several records relating to the running of the service. These included staff recruitment and training records, medicine records and records associated with the provider's quality assurance systems. We also spoke with and received feedback from partner agencies.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records, policies and procedures and risk assessments and we spoke with 3 relatives.
Updated
26 September 2023
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.
About the service
Stoke View is a residential care home that provides personal care and support for up to 9 people with a learning disability, autism or who have complex needs associated with their mental health. At the time of the inspection there were 9 people living at the service.
People’s experience of using this service and what we found
Right Support:
People were not always supported to have maximum choice and control of their lives and staff were not always supporting people in the least restrictive way possible. The service could not always demonstrate they were acting in people’s best interests.
People were not always protected from the risk of harm as staff did not always have all the information needed to meet people's needs safely. People were able to choose how they spent their time and were supported by staff to take part in activities and pursue their interests.
Right Care:
People’s care and support plans were not always reflective of their range of needs. However, staff knew people well and understood how to communicate effectively with people. Staff respected the people they supported and provided care that was caring and compassionate. It was clear from what we were told that people and staff had developed good relationships.
Right Culture:
The management team had created an open culture where constructive feedback was encouraged. People and their relatives knew how to make a complaint and felt confident they would be listened to. However, we found more work was needed to ensure the service was operating in accordance with the regulations and best practice guidance.
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 21 March 2019).
Why we inspected
We received concerns in relation to safeguarding, staffing levels, the management of people’s monies, restrictive practice as well as the culture and governance of service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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.
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 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 Stoke View Residential Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, safeguarding people from abuse, the need for consent, notifications and governance at this inspection. We have also made recommendations in relation to person centred care, staffing levels, homely remedies and environmental safety.
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 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 continue to monitor information we receive about the service, which will help inform when we next inspect.