Background to this inspection
Updated
6 May 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.
Inspection team
The inspection team consisted of two inspectors, a member of the CQC medicines team and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in three ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager who was not registered with the Care Quality Commission. The provider explained that they had applied to register the 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. We sought feedback from the local authority and professionals who work with the service. 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 one person who used the service and greeted other people we met. We spoke with six staff members including the nominated individual, the manager and four members of care staff. We spent time observing people as a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included one person’s care records and two people’s medication records. We looked at four 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 and two more people’s care records.
Updated
6 May 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
Winray care housing provides personal care and support in three settings to people with learning disabilities and/or autistic people. Nine people were receiving personal care at the time of the inspection.
People’s experience of using this service and what we found
Right Support
People were not always supported by staff to fulfil their interests.
The service worked with people to plan for when they experienced periods of distress.
People were able to personalise their rooms.
Staff supported people to have their medicines as prescribed. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care
Staff did not always provide care in a respectful manner. In other cases, staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
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.
Right culture
People did not always live empowered lives.
Monitoring systems did not always pick up shortfalls and the provider did not always know when to submit statutory notifications about serious events to the CQC.
Staff and people could feedback about the quality of care and the provider worked with health and social care professionals when things went wrong.
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 (published 7 March 2019).
Why we inspected
The inspection was prompted in part due to concerns received about safeguarding adults from abuse. A decision was made for us to inspect and examine those risks. We also undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
Enforcement and recommendations.
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 a breach in relation to dignity and respect. We made two recommendations about safe recruitment and person-centred care.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.