S E L F Limited - 14 Park View

Updated 27 July 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 Care Act 2014.

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

An inspector carried out the inspection. An Expert by Experience made telephone calls to relatives of people who used the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

S E L F Limited - 14 Park View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. S E L F Limited - 14 Park View is a care home without nursing. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authorities and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

This information helps support our inspections.

During the inspection

We spoke with seven people who used the service and three relatives about their experience of the care provided.

We spoke with nine members of staff including the registered manager, team leader, senior care staff and care staff. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included three people’s care records and two medication records. We looked at a variety of records relating to the management of the service, including staff files, policies and procedures.

Updated 27 July 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

S E L F Limited - 14 Park View is a care home and provides accommodation and support for up to nine people living with a learning disability. There were nine people living at the service when we visited.

People’s experience of using this service and what we found

Right Support

Since the last inspection, practices and the culture within the service had significantly improved. The provider had employed a new registered manager who supported people to live free from unwarranted restrictions. People, including those unable to make decisions for themselves, now had as much freedom, choice and control over their lives as possible. Staff effectively managed risks to minimise restrictions.

The provider and registered manager had improved staffing levels and ensured enough staff were on duty. Where people had support, they told us this was flexible, available when they needed it and to the level they needed. People were supported safely with medicines and infection prevention and control practices reflected good practice. Staff managed the safety of the living environment and equipment well through checks and action to minimise risk. Work had been completed to repair the heating system.

The registered manager had worked with staff to improve the quality of record-keeping. Staff now kept clear and detailed care records, which were accurate, complete, legible and up-to-date. Every person’s record contained a clear one-page profile with essential information about dos and don’ts to ensure that new or temporary staff could see quickly how best to support them. People were involved in discussions about their support and given information in a way they understood.

Right Care

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had received additional training around how to recognise and report abuse. The provider had significantly improved how they looked after people’s money and all spending could be easily accounted for. Wherever possible people looked after their own money. People now had care and support plans that were personalised, holistic, strengths-based and reflected their needs and aspirations. People, those important to them and staff reviewed plans together regularly. Staff now ensured decisions about any routines in the service were based on people’s choices.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff enabled people to access specialist health and social care support in the community. People who lacked capacity to make certain decisions for themselves or had fluctuating capacity now had decisions made by staff on their behalf in line with the law. People benefitted from reasonable adjustments to their care to meet their needs, and their human rights were respected. This was because staff put their learning into practice.

People received support to eat and drink enough to maintain a balanced diet. People were involved in choosing their food, shopping, and planning their meals. Staff now supported people to be involved in preparing and cooking their own meals in their preferred way. Mealtimes were flexible to meet people’s needs and to avoid them rushing meals.

Right culture

Since the last inspection CQC has cancelled the previous manager’s registration via enforcement powers. This was due to them creating a closed, controlling and restrictive culture in the service, which had failed to promote people’s human rights. Subsequently the provider critically reviewed the service and put effective measures in place to radically change the ethos in the service. The service was now open to new ways of working and practices were introduced to promote independence and inclusivity.

People received good quality care, support and treatment because trained staff could meet their needs and wishes. The new registered manager ensured staff placed people’s wishes, needs and rights at the heart of everything they did. They sought advice and feedback from everyone involved in people's care. There were formal listening events for family and friends to share their views and discuss issues with staff and comments were actioned by the provider.

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 14 January 2022). We identified breaches in relation to safe care and treatment, safeguarding, dignity and respect, staffing and good governance.

Following the inspection, we took enforcement action to cancel the manager’s registration and they are now no longer able to work as a registered manager of a care service. We issued the provider a warning notice in relation to the breach around good governance.

We also served requirement notices and the provider was required to provide actions plans detailing how these breaches would be addressed.

Why we inspected

We undertook this focused inspection to check whether sufficient action had been taken in response to the Warning Notice and requirement notices we served following our last inspection.

The provider completed an action plan after the inspection to show what they would do and by when to improve dignity and respect, safe care and treatment, safeguarding service users from abuse and improper care and staffing levels. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to good. This is based on the findings at this 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 coronavirus and other infection outbreaks effectively.