Archived: Life Opportunities Trust - 6a Sewells

Life Opportunities Trust – 6a Sewells is a ‘care home’ providing accommodation for up to seven older people with learning disabilities. At the time of the inspection there were six people living at the home.

People's experience of using the service and what we found.

Individual risks were not always assessed or managed to help keep people safe or to ensure that the care provided consistently met their assessed needs.

People who had specific time allocated for one to one activity did not always receive this.

People were referred to health professionals when needed, however the resulting guidance was not always followed by staff.

People, or the management team, could not be assured that new staff were adequately checked to ensure they were suitable to work with people. We found no evidence that people had been harmed however, systems were not robust enough to demonstrate staff recruitment was effectively managed.

People were not supported by staff who had been trained to meet their specific care needs.

Medicines were administered when required but staff did not maintain accurate records.

Audits and checks of the service were not routinely completed. This meant the management team were not aware of concerns identified during this inspection in relation to risk management, recording and governance.

People had regular staff who they knew well and who they felt safe with. One person said, “[Staff name] is my favourite, they are very nice to me and I like it when they are here.” Staff told us they felt there were enough staff to support people safely.

We were assured the service were following safe infection prevention and control procedures to keep people safe.

The service didn’t always apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Although this was a focused inspection which meant we only looked at two domains, Safe and Well-led rather than all five domains we did find people did not always receive person-centred care which promoted their dignity, privacy and human rights. People were not always supported to follow their interests and take part in activities in the local community (when there were no COVID-19 restrictions).

The service did not have a registered manager. A lack of oversight of the service by the provider meant we were not assured that people received high quality care and that the provider was committed to continually improving 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

The last rating for this service was Good (30 November 2017).

Why we inspected

We received concerns in relation to infection control procedures, managing people’s changing health needs safely, recruitment and overall governance of the service. As a result, we undertook a focused inspection to review the key questions Safe and Well-Led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Life Opportunities Trust – 6a Sewells on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, in particular risk management and good governance at this inspection.

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

Follow up

We will request an action plan for 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.

Life opportunities trust-6a Sewells is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates seven people in one adapted building. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People felt safe and staff were aware of how they needed to maintain people’s safety/ this was in relation to medicines, individual risks, the environment and going out. There were sufficiently trained staff to meet people’s needs and they felt supported by the management team.

People were supported in a person centred way which included meeting their care needs and in relation to hobbies and interests. Care plans were detailed and people were involved in developing these.

People were treated with dignity and respect. Staff worked in a way that demonstrated they treated the service as people’s homes and they told us this was the ethos of the management team. People and their relatives told us that they did not have any complaints but felt confident to raise any issues if they arose.

There were systems in place to monitor the quality of the service and this included involving people in, and listening to people about, the running of the home. People, their relatives and staff told us that they felt the service was well run.

Life Opportunities Trust- 6a Sewells provides accommodation and personal care for up to seven people with varying learning and physical needs. There were seven people living at the service on the day of our inspection.

There was a registered manager in post, however, they were on a temporary secondment for the organisation in a different role and the home was being managed by an acting manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At the last inspection on 3 June 2013, the service was found to be meeting the standards. At this inspection we found they had continued to meet the standards. However, the home did not always send notifications to the CQC as required and this was an area that required improvement.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS)

We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that most people living at the service were able to make their own decisions and those who were unable had their capacity assessed. The manager and staff understood their roles in relation to DoLS. DoLS applications for people who received constant supervision were pending an outcome.

People told us that they received care that met their needs in a way that they preferred. People were involved in planning their care and deciding how they spent their time. Activities were based around people’s hobbies and interests.

People were positive about the food and were involved in preparing meals. There was regular health and social care involvement. People were positive about the staff and there were established relationships between people and staff. Staff knew people well. People’s feedback was sought and complaints were acted upon.

Staff had received appropriate training and supervision. There was effective leadership and guidance in the home. There were systems in place to monitor the quality of the service and address any issues identified.

People told us that there were a lot of activities for them to take part in. One person told us that they went to the YMCA three times a week. Another person said that they had a cat and went shopping every week to buy food for themselves and their cat.

We saw that people chose what they wanted to eat. We looked at a book of photographs that were used for people to plan the menu for each week. One person who cooked their own food did their shopping themselves at a local supermarket and was encouraged to buy fresh fruit and vegetables.

We saw that on the day of our inspection the home was clean and bright. We looked at all of the bedrooms, the lounge, dining area, kitchen and bathrooms and found these to be clean and dust free.

The home had 10 permanent day staff, four permanent night staff and 14 bank staff. However, the home did sometimes employ agency staff to ensure that the staff levels were maintained. The home ensured that the agency care workers were qualified to provide care to the people who lived there.

We saw that people's records were completed fully and were up to date.