25 January 2022
During a routine inspection
Poppy Cottage Limited is also a domiciliary care service. The service informed us they had provided domiciliary care to people in their own homes in the community in the past, but were not doing so at the time of our inspection.
People’s experience of using this service and what we found
People's risks were not always assessed appropriately to identify or effectively reduce risk in areas such as fire safety, health, finances and safety of chemicals. Governance systems did not manage risks to people well, or ensure records were well managed.
People's care and support was provided in a safe and clean environment. Systems were followed to ensure people were protected from abuse and poor care. The provider reviewed incidents but this did not include themes or outcomes. We have made a recommendation about this. People and relatives told us they felt the service was safe and that staffing levels had improved. Medicines systems had generally improved, however we have made a recommendation about the management of medicines records and audits. Staff recruitment checks were completed before they started supporting people. We have made a recommendation about the recruitment records.
The service did not effectively meet two people’s hydration needs to maintain their health and wellbeing. Other people received effective support to monitor their nutrition.
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 did not consistently support this this practice. We have made a recommendation about this.
People's care, treatment and support plans were holistic. However, they did not always include enough information about identified needs or how to provide support. We have made a recommendation about this.
People were supported to be independent, pursue their interests and achieve their own goals. Staff protected and respected people’s privacy and dignity. People told us they staff were caring and treated them well. We have made a recommendation about how people prefer to be addressed.
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.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right support: The service supported people to have the maximum possible choice, control and independence. This was not consistently supported by recorded best interest decisions.
Right care: Staff provided person-centred care and promoted people’s dignity and privacy. This was not consistently supported by documentation, which did not always demonstrate how people’s human rights were considered and upheld.
Right culture: People were at increased risk of harm because the provider did not manage risk well to protect people. There was a transparent and open and honest culture between people, those important to them, staff and leaders.
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 22 September 2021).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made. The provider remained in breach of two of the regulations and we found a new breach of regulation. It was no longer in breach of other regulations.
This service has been in Special Measures since 8 September 2021. 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. The service is now rated requires improvement.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last 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. This included checking the provider was meeting COVID-19 vaccination requirements.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
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 Poppy Cottage Limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 of regulation in relation to risk assessment, good governance and meeting people’s hydration needs.
We issued a notice of decision to impose conditions upon the providers registration. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.