Frinton House provides accommodation for up to six younger adults who have learning disabilities. There were six people living at the home at the time of our inspection. People’s needs were varied, some displayed behaviours that challenged and a number were on the autism spectrum. People had complex communication needs and required staff who knew them well to meet their needs. Frinton House is owned by Consensus Support Services Limited who have a number of care homes nationally. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
This comprehensive unannounced inspection took place on 28 January and 02 February 2016.
Good governance had not been maintained. Although there were systems and processes in place they had not been carried out effectively to ensure required improvements were made to the service. Audits by the registered provider had not been carried out in a timely manner and where they had been done the reports of these audits had not been sent to the home.
Areas of the home had been adapted to meet the needs of one person and although this had made a significant difference to this person, this, and some of the behaviours displayed by this person had a negative impact on some of the people at Frinton House. Whilst the registered manager had identified that the service was not able to continue to meet this person’s needs without it impacting on others, there had been a delay in taking action to ensure that more appropriate accommodation could be found. At the time of our inspection this matter was beginning to be addressed.
There were safe procedures in place for the management of medicines. However, protocols for the use of medicines prescribed on an as required basis were not detailed and it was therefore unclear when these medicines should be administered.
Although individual risks assessments were carried out, when changes occurred to people’s needs they were not always updated to ensure that people were safe and had all the equipment they needed to maintain their safety.
The registered manager and staff had training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, had assessed that some restrictions were required and made referrals for authorisations. However, there was no documentation to demonstrate that the least restrictive option had been used.
Some people led very busy lives which included attending day centres, college courses in the evenings and they had regular opportunities for walking, shopping and eating out in cafes and restaurants. One person was supported to attend church regularly. However, others had fewer opportunities for daily activities and records showed a strong emphasis on car rides and watching DVDs. It was not always clear what the purpose of outings were and there were no systems in place to monitor if people were happy with these outings.
Staff knew people’s individual needs and were able to describe to us how to provide care to people that matched their assessed needs. However, we observed some care practices that did not demonstrate that people’s dignity was always maintained or that a personalised service was provided.
People had access to healthcare professionals when they needed it. This included GP’s, dentists and opticians.
People told us that they liked the food. Relatives also spoke positively of the food provided. One relative said that the, “Meals are top quality, wonderful.” Systems were in place to ensure that there were sufficient quantities of fresh food available and the location of the home meant that additional shopping could be done to cater for people if they changed their mind about what was on the menu.
There were enough staff who had been appropriately recruited, to meet the needs of people. Staff were aware of how to recognise and report safeguarding concerns.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special
measures’ by CQC. The purpose of special measures is to:
• Ensure that providers found to be providing inadequate care significantly improve.
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made. Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.