Background to this inspection
Updated
26 August 2022
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 Health and Social Care Act 2008.
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
Two Inspectors carried out the inspection.
Service and service type
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.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 23 June 2022 and ended on 29 July 2022. We carried out two site visits to the service on 30 June 2022 and 6 July 2022 and requested additional evidence which was reviewed on 29 July 2022.
What we did before inspection
We reviewed information we had received about the service. We sought feedback from the local authority who work with the service. We received a Provider Information Return (PIR) from the service. A PIR is information providers send us to give some key information about the service, what the service does 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 two people who used the service and three relatives about their experience of the care provided.
We spoke with five members of staff including the registered manager.
We spent time observing people and the care they received.
We reviewed a range of records. This included four people’s care records and three medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with professionals who visit the service.
Updated
26 August 2022
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.
About the service
New Partnerships Lynray and Peach Cottage is a residential care home providing personal care and support to up to six people with a learning disability or autistic people. At the time of our inspection there were six people using the service but only three of these received personal care as detailed in the regulated activity. The service consisted of a cottage where three people lived, a cottage where two people lived and an annexe space where one person lived. Each person had their own bedroom with en-suite bathrooms.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.
Right Support
• The staff team supported people to have choice, control and independence. However, the service had five full-time vacancies and was heavily reliant on agency staff.
• Management and staff focused on people’s strengths and promoted what they could do.
• The staff team supported people to identify their goals and where staffing levels made it possible, to work towards these.
• The registered manager and staff team worked with people to plan for when they experienced periods of distress, so that their freedoms were restricted only if there was no alternative.
• The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
• Staff supported people to take part in activities and pursue their interests in their local area.
• Staff enabled people to access specialist health and social care support in the community.
• The staff team supported people with their medicines in a way that promoted their independence. Agency staff did not administer medication.
Right Care
• People received kind and compassionate care; however, some agency staff members were observed to deliver task-based support.
• The core staff team understood and responded to the individual needs of the people they supported, however, there were not enough of them.
• Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
• People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The service used a high level of agency staff and tried to ensure this was consistent.
• People could take part in activities and pursue interests that were tailored to them.
• The registered manager and staff team assessed risks people might face.
Right culture
• The registered manager and staff team worked towards helping people lead inclusive and empowered lives.
• The registered manager had recently joined the service and had been registered at a similar service in a different area which was rated good under their management.
• The registered manager told us they were in the process of embedding new governance structures and alongside the provider, seeking to recruit permanent staff members.
• Staff felt supported by the registered manager but were concerned there was not enough support for them or her, from the provider.
• Core staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
• Staff turnover had been high, and the service had five full time vacancies for support staff. The service made use of agency staff to help support people to receive consistent care, however, agency staff did not always know them well.
• The needs and safety of people form the basis of the culture at the service. The registered manager and staff team understand their role in making sure that people are always put first. They provided care that was person centred.
• The registered manager was working to create a learning culture. However, staff told us they did not all feel valued by the provider.
We made two recommendations to the provider:
We recommend the provider ensures that all updates to training are completed by the staff team within a short time frame.
We recommend the provider supports people and those that are important to them, to express their views regarding end of life care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
This service was registered with us on 01 December 2020 and this is the first inspection
The last rating for the service under the previous provider was good, published on 03 October 2018.
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. An unrated infection prevention and control inspection report published 14 April 2021 found we were assured that the service was managing this well.
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 as necessary to keep people safe as a result of this inspection.
We will continue to monitor this service.
We have identified breaches in relation to person-centred care. Please see the action we have told the provider to take at the end of the 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.