Lansdowne Road (67-71)

Updated 10 October 2023

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 Health and Social Care Act 2008.

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 completed by 3 inspectors.

Service and service type

Lansdowne Road (67-71) is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us.

Lansdowne Road (67-71) is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection and reviewed the last inspection report. We sought feedback from the local authority. 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.

During the inspection

We spoke with 7 people who used the service for their feedback about the care and support they received. We spoke with 13 members of staff. This included the registered manager, operations director, a senior support worker, a domestic, maintenance person and 8 support workers. We spoke with 3 visiting professionals and a professional by telephone.

We looked at a range of documents including in part, 6 people's care plans and risk assessments, 3 staff recruitment records, training records, DoLS records and mental capacity assessments. We also reviewed audits, incident and medicines management and governance. We also conducted checks of the building.

After the inspection site visit, we contacted 6 relatives for their experience of the service.

Updated 10 October 2023

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

Lansdowne Road (67-71) is a residential care home providing personal care for up to 26 people with a learning disability and or autism. At the time of the inspection, 25 people were living the service.

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

Right Support: People’s support plan and risk assessment guidance provided to staff of actions required to manage and mitigate known risks, were not consistently followed by staff. Guidance for staff was also limited in places, however, action was being taken to make improvements and was ongoing.

Incident management procedures such as de-brief meetings and incident analysis to support learning opportunities needed to improve. Physical intervention was used as a last resort, whilst staff had recently received enhanced training, they were not sufficiently confident. Further training and support were required.

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 did not support this practice.

Cleaning of the environment needed improving in some areas, to ensure effective infection prevention and control measures.

Right Care: The service had enough staff deployed to meet people’s individual needs and keep them safe. Staff had been recruited safely.

People, relatives, and external professionals provided positive feedback on the staff’s approach to care and support.

People were supported to lead active and fulfilling lives, there was a person centred approach, independence was promoted, and staff supported people effectively to achieve positive outcomes.

Right Culture: The provider’s systems and processes to monitor quality and safety were found to be ineffective. A recent internal action plan had been developed to address the required improvements identified by a local authority visit. Whilst this advised overall actions had been completed and signed off, we identified continued shortfalls.

Staff had received training for working with autistic people and people who have a learning disability. Staff meetings and supervisions were held and provided an opportunity to raise concerns and ask questions. Staff were positive about working at 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 rated inspection for this service was good (published 4 March 2018).

Why we inspected

We received concerns in relation to the management of medicines and people’s care and support needs. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

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 and Well-led sections of this full report.

The registered manager took some immediate actions to mitigate risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ Lansdowne Road (67-71) link on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to governance procedures at the service. 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 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 continue to monitor information we receive about the service, which will help inform when we next inspect.