Archived: Dorset Learning Disability Service - 56 Maiden Castle Road

Updated 22 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

The inspection was carried out by one inspector.

Service and service type

Dorset Learning Disability Service - 56 Maiden Castle Road is a ‘care home’ . People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced

What we did before inspection

We looked at all the information we had received about and from the home. We used the information gathered as part of monitoring activity that took place on 19 April 2022 to help plan the inspection and form our judgements. We sought feedback from commissioners and the local authority. We used all of this information to plan our inspection.

During the inspection

Inspection activity started on 14 June 2022 and ended on 1 July 2022. We visited the home out of hours on 14 June 2022 and during the day on 15 June 2022.

We spoke, Makaton signed and communicated with four people and one relative about their experience of the care provided. People who used the service who were unable to talk with us used different ways of communicating including using Makaton, pictures, photos and their body language. Makaton is a form of sign language.

We spoke with four members of staff including the registered manager and support workers. We spent time observing people as they were not all able to tell us their experiences.

We reviewed a range of records. This included two people’s care records and four medication records. We looked at three 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 held two video conference calls with the provider’s representatives and the acting manager. We continued to seek clarification from the provider to validate evidence found. We looked at training and quality assurance records.

Updated 22 July 2022

About the service

Dorset Learning Disability Service - 56 Maiden Castle Road is a residential care home providing personal care to four people at the time of the inspection. The service can support up to four people.

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.

Based on our review of the safe, responsive and well led key questions the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

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

Right Support

Some people were not always safe from harm from the people they lived with. There were restrictions in place and some punitive practices had developed. The service did not always support people to have the maximum possible choice, independence or have control over their own lives.

Staff did not consistently follow people’s risk management plans and this placed some people at risk of harm.

Staff were committed to supporting people to live full lives. However, this was difficult to achieve because the high use of agency staff impacted on people ability to do the things they enjoyed both in and out of the house.

The registered manager had not reviewed incidents when people had harmed each other. There was also no opportunity for staff to learn from these situations and improve practice.

Right Care

Staff did not always support people in respectful ways. This was because they asked them not to do things without explanations, or reasoning, or in line with their support plans. Improvements were needed to make sure people were supported by staff in a personalised way.

We observed caring interactions between some staff and people. Some staff were observed to encourage people to be as independent as possible. Staff told us they were very fond of and cared about the people at the home. Some people sought out staff’s company and laughed and smiled with them.

Right culture

People’s care and support was not always person centred and there was a culture of doing things a certain way because that was what had always been done. We were not assured people's support plans were being followed.

Governance systems did not ensure people were kept safe and received a high quality of care and support in line with their personal needs and preferences.

The registered manager resigned with immediate effect during the inspection. The provider was responsive to initial feedback and ensured that an acting manager who knew people well was covering the home.

Both the acting manager and provider’s representative addressed the shortfalls and concerns we identified during the inspection. We have not yet been able to check the impact of these changes in practice on people’s experiences.

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 27 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full 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.