About the service Chaseways is a residential care home providing personal and nursing care to 4 people aged 65 and under at the time of the inspection. The service can support up to 6 people who require daily support with their learning disabilities and / or mental health needs. The building has been adapted so people can live within their own self-contained accommodation.
The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service did not receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were not supported by sufficient numbers of staff. Risks to people’s safety and wellbeing were identified, but not reviewed when their needs changed. Staff had unnecessarily restricted people’s freedom through use of restraint without following best practices guidance. People were not protected from the risk of harm or abuse as incidents were not investigated.
Staff did not receive training to enable them to fully support people’s needs. Staff did not feel supported by the interim manager. People’s nutritional needs were not consistently well met.
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.
The service didn’t always apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people did not fully reflect the principles and values of Registering the Right Support as people had a lack of choice and control, limited independence and limited inclusion in the community.
Governance and oversight of the service did not identify areas of improvement. Management arrangements in the service were not sufficient to keep people safe from harm. The interim manager and provider did not act in an open and transparent manner when things went wrong. People were not effectively engaged with by the management of the service.
People were safely supported with their medicines. People lived in a clean environment. People were able to see health professionals when needed and staff supported them to attend these appointments. The environment was adapted to meet people’s needs, however some areas required ongoing maintenance or decoration.
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 07 November 2018).
Why we inspected
The inspection was prompted due to concerns received about inappropriate use of restraint along with people at risk of harm from lack of staffing, effective training, lack of management oversight and people’s nutritional needs being unsupported. A decision was made for us to inspect and examine those risks.
As a result, we undertook a focused inspection to review the Key Questions of Safe, Effective and Well-led only.
We have found evidence that the provider needs to make improvements. Please see all sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
We found evidence during this inspection that people were at risk of harm from this concern. We reported these concerns to the provider who took immediate action to make improvements and promote people’s safety. We also informed the local authority of our concerns. We found the actions taken by the provider had been effective in mitigating the urgent risks, however, also found further improvements were required.
On 15 February 2020 we received further information that suggested staff were not supported to raise their concerns and that staff were not being supported. We found no further evidence at that time to substantiate the concerns received on this occasion. Please see the 'Effective' section of this report.
Enforcement
We have identified breaches in relation to safe care and treatment, staffing, safeguarding service users from abuse and improper treatment, meeting nutritional needs, training and support for staff, good governance, and being open when things go wrong at this inspection.
The service is rated as inadequate overall and in the Effective and Well-Led key questions.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chaseways on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner. 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.
The overall rating for this service is 'Inadequate' and the service has been placed in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.