The Hall

Ratings

• Overall

  Inadequate

• Safe

  Inadequate

• Effective

  Requires improvement

• Caring

  Requires improvement

• Responsive

  Requires improvement

• Well-led

  Inadequate

Our view of the service

We completed an assessment on The Hall between 22 and 30 May 2024. People were at risk of harm, and in some cases had been harmed. 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’ (RCRSRC) 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. The provider failed to ensure they met the principles of RCRSRC. People had not been safeguarded from the risk of abuse. People had been unlawfully restrained by staff, during incidents where de-escalation techniques had not been used and physical intervention was not the least restrictive option or in line with the person's positive behaviour support plan. People were supported by staff who lacked the competence and skill to support them in a positive way. We identified multiple and widespread concerns. The provider had failed to identify and improve the service for people living there. There was a lack of leadership, governance and oversight and statutory and legal requirements had not been met. Documentation was poor and not up to date, this left people at avoidable risk of harm. We identified 9 breaches of the legal regulations in relation to a lack of person-centred care, the need for consent, safe care and treatment, safeguarding, good governance, staffing, fit and proper persons employed, duty of candour, and notification of other incidents. We took urgent action to prevent the provider from allowing anyone to move into the service. We placed conditions on the providers registration for them to send us weekly action plans advising us how they planned to improve the service.

People's experience of this service

People’s experience of living at the service was poor. People had been subjected to numerous physical interventions, which in some cases were unlawful and in some occasions staff used excessive force. When incidents of concern occurred, these were not always reported to the local authority safeguarding team, or the CQC to ensure appropriate oversight and action was taken. People lived in a chaotic environment with frequent incidents occurring. Staff told us two people were not compatible to live together, however this had not been raised with placing authorities. People witnessed incidents of abuse regularly. People were supported by staff who lacked the skills and competence to support them in a safe positive way. Agency staff, and permanent staff involved in physical interventions did not have the training to inform them how to safely support people.