Background to this inspection
Updated
7 October 2020
The inspection
This was a targeted inspection to check if the provider had met regulations 9 (Person-centred care), 10 (Dignity and respect), 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which they were breaching at our last inspection in January 2020.
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
This inspection was undertaken by one inspector on 9 September 2020.
Service and service type
Life Opportunities Trust - 329 Martindale Road 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 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. We telephoned the provider on arrival to the care home to check if anyone was unwell and if it was safe for us to enter the home.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included the action plan the provider sent to us following the previous inspections saying what they would do and by when to improve. We received feedback from the local authority and other agencies. We reviewed information about important events the provider had notified us about what had happened at the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager and the provider's director of care. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at the care plans for two people and a variety of records relating to the management of the service.
After the inspection
We spoke with two relatives, four support workers and three adult social care professionals who have worked with the service. We looked at quality assurance records and other records relating to the management of the service. We continued to seek clarification from the provider to validate evidence found.
Updated
7 October 2020
About the service
Life Opportunities Trust - 329 Martindale Road is a care home situated in a residential street in Hounslow. It is registered to provide personal care for people aged 18 and over. It supports adults with multiple or complex needs such as profound learning and physical disabilities and who are living with additional conditions, including epilepsy and dementia. People had their own bedrooms. They shared the kitchen, dining room, living room, bathing and laundry facilities, a sensory room and garden. A team of staff supported people during the day and overnight.
The service has been developed and designed in line with the principles and values that underpin
Registering the Right Support (RRS) and other best practice guidance in relation to environmental
considerations. The service was registered to provide support to up to seven people and there were four people using the service at the time of our inspection.
People’s experience of using this service and what we found
There had been a number of improvements to the care people received. People were treated with dignity and respect. People's support and risk management plans set out how to avoid the risk of skin damage and discomfort. There was a planned approach to offering people support to regularly try activities that were meaningful to them.
The provider had a number of systems in place to monitor the quality of the service and had implemented an action plan to make sure the service was compliant with regulations. However, ongoing improvement was still required to ensure the quality assurance systems were properly embedded and reliable, and improvements were sustained.
At the time of the inspection the service applied the principles and values of Registering the Right Support. 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. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having opportunities to try activities that were meaningful to them and gain new skills and become more independent.
People using the service and staff experienced a challenging time as a result of the COVID-19 pandemic. Staff had supported people to shield based on health professionals' advice and this meant some people had not been able to access their community as much as would have been preferred.
There were appropriate procedures for infection prevention and control.
The service worked with other agencies to make sure people received joined up care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 requires improvement (published 27 February 2020) and there were multiple breaches of regulations. These were in relation to treating people with dignity and respect; providing care to meet people's needs and reflect their preferences; managing risks to people's safety; and having effective systems in place to monitor the quality of the service. This service has been in 'special measures' since 31 January 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in special measures.
Why we inspected
We undertook this unannounced targeted inspection to check if the provider had met regulations 9 (Person-centred care), 10 (Dignity and respect), 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which they were breaching at our last inspection in January 2020. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
CQC have introduced targeted inspections to follow up on Warning Notices, breaches of regulations or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found there were improvements regarding the provider having effective systems in place to monitor the quality of the service, so we widened the scope of the inspection to include the whole of the well-led key question and to award it a rating.
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.
Follow up
We will request an action plan for the provider to understand what they will do to continue 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.