Telegraph Road

Updated 25 August 2023

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

The inspection was carried out by 2 inspectors.

Service and service type

Telegraph Road is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Telegraph Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, there was a manager newly in post who intended to apply to become the registered manager.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. 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. We reviewed information we had received about the service and sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spent time with 3 people getting feedback and observing the quality of care and support they received. This helped us to understand the experiences of people who we were unable to communicate with effectively. We received feedback from 2 relatives about their experience of the care provided. We looked at 7 staff files in relation to recruitment and reviewed a variety of records relating to the management of the service, including medicines management, risk assessments and quality assurance records. We spoke with 7 members of staff including the manager, regional manager, a manager providing support to the new manager and 3 care workers.

Updated 25 August 2023

About the service

Telegraph Road is a small residential care home providing personal care for up to 4 people. The service provides support to people who live with learning disabilities and autistic people. At the time of our inspection there were 4 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.

Right Support: The service was not maximising people’s choices, control or independence. 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 always support this practice. We could not be assured the service was working within the principles of the Mental Capacity Act 2005 (MCA). We have made a recommendation about this.

Right Care: People were not always treated with dignity and respect and were not supported to lead inclusive and empowered lives. People had care plans in place. However, these were not always written in a way that was person centred and easy to understand; we found a lack of detail to guide staff on how to support people safely and consistently. People were at increased risk of harm because staff did not always have the information, they needed to support people safely. Medicines were not always managed safely. We were concerned people were not always safe from the risk of financial abuse. We have made a recommendation about this.

Right Culture: The service was not always well led. The quality assurance systems to assess and monitor the service were not always in place, and where they were, they were not always effective. We found the provider did not have enough oversight of the service to ensure it was being managed safely and quality maintained. Quality assurance processes had not identified all of the concerns in the service. Records were not always complete, or person centred. This meant people did not always receive high quality care. However, the provider was responsive throughout the inspection and took prompt action to address the concerns. There is a new manager, deputy manager and regional manager in post who implemented an action plan and introduced new processes and systems. These processes and systems need time to become embedded within the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 1 December 2020, and this is the first inspection.

The last rating for the service under the previous provider was good, published on 29 December 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement and Recommendations

We have identified breaches in relation to assessing risk, medicines management, dignity and respect, person centred care and management oversight.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.