Background to this inspection
Updated
16 March 2024
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.
Inspection team
The inspection was completed by 2 inspectors. On the first day of inspection 1 inspector visited the service and on the second day of inspection 2 inspectors were present.
Service and service type
Melton Short Breaks Service is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Melton Short Breaks Service is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people there to speak with us.
Inspection activity started on 15 November 2023 and ended on 24 November 2023. We visited the location’s service on 15 and 17 November 2023.
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. 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 used all this information to plan our inspection.
During the inspection
We reviewed care records for 5 people who regularly stay at Melton Short Breaks Service. We sought the views of 1 person, 3 relatives and 2 health professionals. We spoke with 9 staff including the registered manager and the service improvement manager.
We reviewed a range of records including medicine records, audits, recruitment files, complaints and accidents and incidents.
Updated
16 March 2024
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
Melton Short Breaks Service is a residential care home providing personal care to autistic people and people with a learning disability, physical disability, sensory Impairment and to younger Adults. Melton Short Breaks service is registered to accommodate up to 6 people at any one time in an adapted building. At the time of our inspection 5 people were staying at the service but they supported 42 people who accessed the service for short breaks at various times throughout the year.
People’s experience of using this service and what we found
Right Support: Medicines were not always managed safely and there had been a number of medicine errors. People’s records sometimes contained conflicting information about their care needs. Not all staff had up to date training.
People were not supported to have maximum choice and control of their lives and staff did not always 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: The service was caring. Feedback from relatives was positive. They felt their loved ones were well cared for and enjoyed staying at Melton Short Breaks Service.
Right Culture: There was a lack of leadership within the service. This had allowed a culture of some poor practices to develop and continue. Staff felt they could not challenge leaders, even when they knew best practice was not being followed. Staff reported issues were not dealt with correctly.
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 requires improvement (published 5 October 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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, responsive 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
We have identified breaches in relation to the management of medicines, keeping people safe from abuse, staff training, mental capacity assessments and managerial oversight 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 continue to monitor information we receive about the service, which will help inform when we next inspect.