Archived: Richardson Court Cottage

Updated 1 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated

Activities) Regulations 2014, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on the 3 and 4 November 2015 and was unannounced. The inspection was conducted by one inspector.

Before our inspection we reviewed the information we held about the service, including previous inspection reports and notifications. A notification is information about important events which the service is required to tell us about by law. We reviewed the provider information return (PIR) and used this information when planning and undertaking the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. The registered manager was asked to send us some further information after the inspection, which they did in a timely manner.

During our inspection we spoke to three members of staff and the locality manager for the organisation. After the visit we spoke with three staff members and one relative by telephone. We observed communication between people who used the service and the staff but were unable to receive verbal feedback from people because of their limited communication skills. We looked at management records including people’s support plans, daily records of activities and support, training records, risk assessments, staffing rotas and quality assurance information.

Updated 1 March 2016

This inspection took place on the 3 and 4 November 2015 and was unannounced. Richardson Court Cottage provides accommodation and personal care for up to three people who have a learning disability or autistic spectrum disorder. The service was last inspected in November 2013 and was found to be compliant with Health and Social Care Act Regulations at that time.

Three people were living at the service; which is a small detached property. Each person had their own bedroom on the first floor and had access to a shared lounge, dining area, kitchen and bathroom. There is a well maintained, secure garden to the back of the property. The service is set within well- secured grounds with a chicken run and poly tunnel for growing vegetables. Within the same grounds is another registered service which was not part of this inspection, there is off street parking within the grounds.

The service is run by a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. The registered manager is also responsible for the other service located on the same grounds as this service.

There were not enough competently trained staff to support people with their individual needs and preferences particularly at times when people required personal care or when meals were being prepared/taken. Staff struggled at times to manage people’s behaviours as well as the other tasks they had to perform.

People were not protected from potential abuse and harm because not all staff were trained to recognise and understand their responsibilities around protecting people and reporting concerns. There was no evidence of regular discussion and learning about the importance of protecting people from potential harm and the processes staff should follow if it occurred.

The provider had not kept the premises well maintained or suitable for the people living there. Some areas of repair had been reported and no action had been taken for a substantial period of time.

Some staff had not received the required training to enable them to competently complete their role safely. People were at risk of improper care and treatment because staff did not have the suitable skills or experience to support them. Some staff had not received regular supervision to allow them to develop or improve.

People had a range of activities which they enjoyed. However, people sometimes missed out on activities and records did not clearly show why this was the case. We observed staff encouraging people to participate in activities in the service which promoted their independence and were enjoyable.

Staff did not support people who may have behaviour which could challenge others in a consistent way. Care plans did not reflect some of the practices staff were observed to use at the time of the inspection.

Auditing systems were in place but were not always effective. The service had not acted to ensure all staff were well trained and supervised to carry out their roles effectively meaning people were at risk of inconsistent support and care.

Staff demonstrated caring and compassionate attitudes towards people but were not always able to give them the attention and support they needed or perform the tasks which they were required to do.

People had individual risk assessments to reduce the potential for harm which were person centred. Environmental risk assessments were kept up to date and available for staff to view.

People were supported to receive their medicine in the way they preferred and audits of medicine ensured errors were identified quickly. Medicines were stored, administered and recorded safely.

Each person had their own individual care file which was personalised and incorporated pictures and an easy read format to help them understand its content. Some documentation had not been updated to reflect the preferences of people or how they should be supported.

An accessible complaints policy was available for people to use if they were unhappy about the care and treatment they received. Staff observed peoples moods and behaviours to determine if they were unhappy with the support they were receiving. Not all staff were clear in the process for receiving or dealing with complaints.

Safe recruitment processes were in place to minimise the risk of inappropriate applicants being employed. Necessary checks had taken place before the commencement of new staffs’ employment.

People were able to choose what food they would like to eat at meal times and were encouraged to help prepare meals with staff. People had access to drinks and snacks when they wished and cultural preferences were incorporated into menus.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.