25 August 2021
During a routine inspection
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 guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and/or autistic people.
People’s experience of using this service and what we found
The service could show how they met the principles of Right support, right care, right culture. The provider had made significant improvements to the service since the last inspection.
Right support:
The model of care and setting maximised people’s choice, control and independence. People lived in a small homely environment where they felt safe and comfortable. The provider had made improvements to the health and safety of the service in relation to the maintenance of the property and ensuring risk assessments were more detailed. Staff supported people to live up to their goals and aspirations. People were encouraged to make choices and decisions in accordance with their level of understanding.
Right care:
Care was person-centred and promoted people’s dignity, privacy and human rights. The provider had made improvements around staffing of the service in relation to recruitment checks, numbers of staff and their deployment. People were supported to maintain their privacy and dignity by a staff team who knew them very well. Staff demonstrated they provided kind and compassionate care to people and relatives. People were supported to maintain links with their culture and family. Staff engaged people in a variety of indoor and outdoor activities in accordance with individual care plans.
Right culture:
Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. People’s representatives and staff spoke positively of the new registered manager and the positive changes they had made to the care provided. The provider had made improvements since the last inspection and now had a regular system of quality checks. People and their representatives were asked by the provider about their opinions of the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
• People’s care and support was provided in a safe, clean, and well-maintained environment which met people’s sensory and physical needs.
• People were protected from abuse and poor care. The service now had enough appropriately skilled staff to meet people’s needs and keep them safe.
• People had their communication needs met and information was shared in a way that could be understood.
• People’s risks were assessed regularly in a person-centred way. Risk assessments were now more detailed and robust. People had opportunities for positive risk taking and were involved in managing their own risks whenever possible.
• People who had behaviours that could challenge themselves or others had proactive plans in place to reduce the need for restrictive practices. Systems were in place to report and learn from any incidents where restrictive practices were used.
• People’s care, and support plans, reflected their sensory, cognitive functioning needs. Support focused on people’s quality of life and followed best practice.
• People received care, support and treatment from trained staff and specialists able to meet their needs and wishes. Managers ensured that staff had relevant training, regular supervision and appraisal.
• People and those important to them, including advocates, were actively involved in planning their care. Where needed a multidisciplinary team worked well together to provide the planned care.
• Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
• Where people were at risk of placement breakdown there was a clear support plan and regular care reviews. Staff worked well with other services and professionals to prevent admission to hospital.
• People were supported by staff who understood best practice in relation to learning disability and/or autism.
• Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs. People and those important to them, worked with leaders to develop and improve the service.
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 inadequate (published 25 October 2019) and there were multiple breaches of regulation. The provider completed an action plan after this inspection to show what they would do and by when to improve.
We carried out an unrated targeted inspection (published 19 September 2020) due to concerns raised by a whistleblower about lack of activities, reporting of accidents and incidents and food and nutrition. We found no evidence at this time that people were at risk of harm from these concerns.
During this comprehensive inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 25 October 2019. During this inspection, the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this inspection to provide assurance that the service is applying the principles of Right support, right care, right culture.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Homewards Limited – 48 Leonard Road on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.