CareTech Community Services Limited - 82 Chaucer Road

Updated 4 February 2020

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.

Inspection team:

This inspection was carried out by two inspectors.

Service and service type:

CareTech Community Services Limited 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 on the first day of the inspection (18 December 2019). We spoke to relatives on the telephone on 19 December 2019 and announced that we would return to the service on 20 December 2019 to review staff files.

What we did before the inspection:

We reviewed information we had received about the service since the last inspection. We received feedback from the local authorities who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection:

We spoke to three people who used the service and two relatives about the experience of the care provided. We saw staff interacting with people during the inspection. We spoke to five staff members including one support worker, two senior support workers, the deputy manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

After the inspection:

The deputy manager sent us further information in relation to training data and quality assurance records.

Updated 4 February 2020

About the service:

CareTech Community Services Limited- 82 Chaucer Road is a residential care home providing personal care to eight younger adults living with a learning disability or autism. People had their own bedrooms with en-suite facilities and shared communal areas such as a kitchen, lounges, bathrooms and a garden.

The service had not been fully developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to eight people. Eight people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

The provider and registered manager had limited oversight of the service and audits were not always effective at identifying where improvements could be made. Staff did not feel supported by the provider and people were not always being supported to achieve good outcomes. Feedback about the service from people was not always actioned in a timely manner.

People were not always kept safe at the service as medicines were not always managed safely. Risks assessments were in place; however, these were not always reflective of people’s current support needs. Some areas of the service needed a deep clean to promote good infection control. There were enough staff to support people safely. However, staff members were not receiving relevant training or frequent supervision to ensure that they were effective in their job roles. We have made a recommendation about the provider’s training programme.

The premises were in need of redecoration and repair in several areas. We have made a recommendation about the environment at the service. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We have made a recommendation about best practice regarding the Mental Capacity Act.

The service did not always consistently 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. The outcomes for people did not fully reflect the principles and values of Registering the Right Support as people were not always supported to follow their interests, have meaningful goals and be a part of their community. We have made a recommendation that the service consult best practice guidance when supporting people living with a learning disability.

People were supported by a kind and compassionate staff team who had gotten to know them as individuals. People’s privacy, dignity and independence was respected and upheld by the staff team. However the provider did not always support staff to do this as they did not keep up to date with best practice guidance.

People were supported to live healthy lives and were supported to eat and drink a varied diet. People had access to a complaints procedure and had been supported to put plans in place for the end of their life.

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 (report published 20 June 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

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, Effective, Responsive 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.

Enforcement:

We have identified a breach in relation to the management and governance of 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 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.