Background to this inspection
Updated
23 September 2021
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 Care Act 2014.
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
The inspection team consisted of two inspectors.
Service and service type
3a Grosvenor Road 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.
The service had a manager registered with the Care Quality Commission. 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 the inspection there was an interim manager in charge because the registered manager was absent from the service.
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 at home to speak with us.
What we did before the inspection
We reviewed information we had received about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service, one relative and two friends of a person about their experience of the care provided. We spoke with five members of staff including the interim manager, senior support worker and three support workers. We spent time observing how staff interacted with people throughout the day.
We reviewed a range of records. This included two people’s care and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, staff training and quality assurance records were reviewed.
After the inspection
We spoke with the nominated individual and operational manager and asked for additional information about the management of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with the Community Learning Disability Team from the Local Authority.
Updated
23 September 2021
About the service
3a Grosvenor Road is a residential care home providing personal care and support for up to three adults with learning disabilities or autistic spectrum disorder. There were two people living there are the time of the inspection. The care home had two bedrooms downstairs and a self- contained flat upstairs with a large accessible garden.
People’s experience of using this service and what we found
There was a lack of consistency in how the service was managed and led. Staff had not always been well supported and the provider’s systems for monitoring quality had not always identified shortfalls in the management of the service. There were not always sufficient staff with the skills needed to support people with complex needs. The provider told us that Covid-19 had caused many challenges which contributed to these issues. They had taken action to make improvements, including with staffing levels. Staff told us this had already made a difference.
People were supported in a personalised way and were leading full and busy lives. A relative said “People have a good quality of life. It’s a homely atmosphere, it’s not clinical, it feels like their home.” Staff were knowledgeable about people’s needs and supported them to be as independent as possible. Staff had undertaken training that was relevant to the needs of people they were supporting. Support plans and risk assessments were detailed and had been reviewed regularly and when people’s needs had changed.
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.
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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of Safe, Effective and Well led, the service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence. People were supported to access the local community and staff were focussed on providing choice and enabling independence.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights. Support was highly personalised and reflected people’s individual needs and preferences.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. Staff described an ethos of supporting people to maximise their quality of life and used positive behaviour support to increase confidence and reduce restrictions on their freedom.
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 18 November 2016).
Why we inspected
This focussed inspection was prompted in part due to concerns received about the safety and management of the service. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-Led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service is Requires Improvement. This is based on the findings at this inspection.
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.
We have found evidence that the provider had taken action to mitigate the risks but changes were not yet fully embedded and sustained. Please see the Safe and Well -Led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 3a Grosvenor Road on our website at www.cqc.org.uk.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.