101 Brook Street

101 Brook Street is a residential care home providing personal and nursing care to up to 6 people. The service provides full respite support for a short period of time to adults who have a range of needs including learning disabilities and autistic spectrum disorder, physical disability, and sensory impairment staying. This is not a permanent home for any people using the service. There were 5 people using the service on the first day of our inspection and 6 people on the second day.

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.

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

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right culture:

The quality assurance system and processes had failed to identify and correct issues we found at the inspection. However, we found some positive aspects of culture as well. The provider had a system to manage accidents and incidents. There was a management structure at the service and staff were aware of the roles of the management team. The management team worked in partnership with a range of professionals. Staff received support through training, supervision, and staff meetings to ensure they could meet people’s needs. Staff told us they felt supported and could approach their line manager at any time for support. The provider had a policy and procedure for managing complaints.

Right support:

Some people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Some people’s risk management and care plans required review and updating, to reflect their current needs. People were protected from the risk of infection. People were treated with dignity; their privacy was respected, and they were supported to be as independent in their care as possible. People were supported to maintain and develop relationships with those close to them.

Right care:

The service identified people’s information and communication needs. However, some people’s care records were not in line with the Accessible Information Standard. People and their relatives were encouraged to participate in making decisions about their care and support. An assessment of people’s needs had been completed, to ensure these could be met by staff. Staff showed an understanding of equality and diversity. Staff respected people’s choices and preferences.

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 24th October 2017).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, Right care, and Right culture.

Enforcement and recommendations

We have identified breaches of 3 Regulations at this inspection, in relation to safe care and treatment, safeguarding service users from abuse and improper treatment, and good governance. We made one recommendation about Accessible Information Standard.

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.

101 Brook Street provides respite care for people who require nursing or personal care for up to six adults who have a range of needs including learning disabilities. There were six people receiving personal care and support at the time of our inspection.

At this inspection we found staff were not supported through regular formal supervision and annual appraisals in line with the provider’s policy, and this required improvement. The registered manager told us that they were aware of this concern and that they have now put a plan in place to ensure every staff received a formal supervision by end of September 2017 and then regularly in the future.

There was a registered manager in post. 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 2008 and associated Regulations about how the service is run.

The registered manager told us that staff were being closely monitored on their shifts and were supported through the staff meetings. Staff meeting records we saw confirmed this. The service provided an induction and training, and supported staff to help them undertake their role.

People and their relatives told us they felt safe and that staff and the registered manager treated them well. The service had clear procedures to support staff to recognise and respond to abuse. The registered manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service which were up to date and included detailed guidance for staff to reduce risks.

There was an effective system to manage accidents and incidents, and to prevent them happening again. The service carried out comprehensive background checks of staff before they started working. Staff supported people so that they took their medicines safely.

The provider had taken action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed.

Staff assessed people’s nutritional needs and supported them to have a balanced diet. Staff supported people to access the healthcare services they required and monitored their healthcare appointments.

People and their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing. Staff prepared, reviewed, and updated care plans for every person.

Staff supported people in a way which was kind, respectful and encouraged them to maintain their independence. Staff also protected people’s privacy and dignity, and human rights.

The service had a clear policy and procedure about managing complaints. People knew how to complain and told us they would do so if necessary.

There was a positive culture at the home where people felt included and consulted. People and their relatives commented positively about staff and the registered manager. Staff told us they felt supported and able to approach the registered manager, at any time for support.

The provider had systems and processes in place to assess and monitor the quality of services people received, and to make improvements where required. They used the results from the audits and made improvements to the service.