Archived: Peacock House

Updated 29 April 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

Two Inspectors carried out the inspection.

Service and service type

Peacock house is a ‘care home’. People in care homes receive accommodation and 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.

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 not a registered manager in post. The service was being managed by a temporary home manager.

Notice of inspection

This inspection was unannounced

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with one person who used the service and two relatives about their experience of the care provided. We spoke with six members of staff including the manager and care support staff.

We reviewed a range of records. This included two people’s care records and three medication records. We looked at three staff files including agency 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 continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 29 April 2022

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

Peacock House provides accommodation and personal care for up to 18 younger adults and older people who are autistic and/or have learning difficulties. At the time of the inspection six people were living at Peacock House.

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

Right Support

Peoples medicines had not always been well managed. Guidance was not always in place for ‘as required’ medicines. Immediately after the inspection the manager put protocols in place. People who suffered with specific health conditions did not always have guidance in place to inform staff how to support them. This was put in place immediately after the inspection. The service worked with people to plan for when they experience periods of distress so that their freedoms were restricted only if there was no alternative. For example, one person had a traffic light system to inform staff which intervention would be necessary and least restrictive depending how distressed the person was. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.

Right Care

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. For example, one person liked spicy foods so the kitchen ensured they could provide this and had several spicy condiments to choose from. People who had individual way of communicating, using body language, sounds, Makaton a form of sign language, pictures and symbols could interact comfortably with staff and others involved in their care and support because staff knew them well. For example, one person uses gestures and the staff understand what they are trying to communicate.

Right culture

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. For example, staff supported a person to regularly go to their local shop as part of their routine they wanted to maintain.

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 9 November 2021) and there was a breach of regulation 17 (Good Governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection there had not been enough improvement and there was still a breach of regulation 17.

Why we inspected

We undertook this focused inspection to due to concerns regarding staffing and staff training but also to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. During inspection we also assess that the service is applying the principles of right support right care right culture.

Follow up

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed. We have identified breaches in relation to good governance such as, daily record keeping and the documentation of medicine management at this inspection.

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.