11 September 2023
During an inspection looking at part of the service
Bentinck Crescent is a small residential care home which can support a maximum of 7 people. The home provides care and support to people with physical disabilities, people with a learning disability and autistic people. At the time of the inspection 7 people were living at the home.
People’s experience of using this service and what we found
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.
Right Support
People were not always 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. Best interest decisions and mental capacity assessments were not in place for all decisions made. DoLS were not up to date for all people living at Bentinck Crescent.
Although people had aspirations recorded in care documentation, they were not always supported to achieve these.
Medicines were not always managed safely. We could not be assured people received their medicines with sufficient time between doses. Some people did not have appropriate paperwork in place for ‘as required’ medicines.
Staff did support people to make decisions about their care, and people, relatives and healthcare professionals were involved in care decisions.
Right Care
Risks to people had been assessed and mitigated in most cases. However, the service had not taken action to mitigate risks around fire evacuations in a timely manner.
People were supported by enough staff to meet their needs. Staff were trained to support people. However, some staff had not received specialist training to meet people’s individual needs.
People and their relatives were happy with the care people received. People felt safe and that staff were kind. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse.
Right Culture
The culture of the service was not always person-centred. Some aspects of the service, such as the times of shifts, were not considered with people’s needs in mind.
Quality assurance and monitoring systems were in place. However, these were not always effective. At the time of the inspection some improvements were being made but were not yet embedded.
Staff said the interim manager was supportive. Relatives thought the service was friendly, people enjoyed living there, although needed more activities.
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 22 September 2022).
Why we inspected
We received concerns in relation to the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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, 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bentinck Crescent on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to medicines management, mitigating risks, person-centred care and consent to care at this inspection. We have also made a recommendation in relation to staffing.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.