13 September 2022
During an inspection looking at part of the service
The Limes is a residential care home providing support and personal care to up to six people in one adapted building. The service provides support to people with learning disabilities, autism and mental health conditions. At the time of our inspection there were three people using the service.
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.
The provider was not always able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.
Right Support:
Risk assessments were not in place when people were at risk of serious harm.
People’s care and support plans were either not in place or out of date and contained information that was incorrect.
Staff did not always support people with their medicines in a safe way. The service did not maintain accurate and up-to-date records about people’s medicines.
People had access to specialist health and social care support in the community.
Right Care:
People were not supported to have maximum choice and control of their lives and staff did not 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.
Where people had a care plan, they were not person-centred. However, people were supported by a core team of staff who knew their needs well and how they liked to be supported.
People received kind and compassionate support. Staff were appropriately trained and had completed training in understanding autism.
Right Culture:
There was limited opportunity for staff to learn from incidents and improve practice.
The provider did not seek feedback or views from people or their relatives.
Staff treated people who used the service in a way which upheld their dignity, privacy and human rights.
Staff felt able to raise concerns and had training in safeguarding. Safeguarding training enables staff to recognise abuse, respond to concerns and support people to live free from abuse and neglect.
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 23 August 2019)
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about how risks to people were being managed. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with how the provider was managing risk along with their compliance to the principles of the Mental Capacity Act, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to consent and not applying the principles of the Mental Capacity Act, safe care and treatment and good governance at this inspection.
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.