27 September 2022
During an inspection looking at part of the service
Crimson Hill Support is a supported living and domiciliary care service which provides support to people in their own homes. The service provides support to people with a learning disability and/or autistic people in Somerset. They also provide a respite ‘short stay’ service for people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection 13 people were receiving personal care.
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 had plans in place to guide staff on how to support them if they became anxious or upset, the plans were not always regularly reviewed or updated. Records demonstrated staff were not always using appropriate restraint on people. The service recorded when staff restrained people, improvements were needed to ensure staff learned from those incidents and how they might be avoided or reduced. 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; the policies and systems in the service did not fully support this practice. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. People were able to pursue their chosen interests.
Right Care
Staff were aware of the signs of abuse and they were aware of how to report any concerns through the appropriate channels. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity in their support for people. Improvements were required to ensure risks to people were fully assessed and mitigated.
Right Culture
The systems to monitor the quality of the service were not fully effective in ensuring shortfalls were identified and actioned. Staff turnover had been high, which meant people were supported by agency staff, this was improving. Staff understood people well and were responsive to their needs.
People and those important to them, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Staff valued and acted upon people’s views.
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 good (published 04 April 2018).
Why we inspected
We received concerns in relation to safeguarding. During the inspection we identified safeguarding concerns relating to the use of restraint. You can see what action we have asked the provider to take at the end of this full report.
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. 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 Crimson Hill Support on our website at www.cqc.org.uk.
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.