Crimson Hill Support

Updated 18 November 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 Health and Social Care Act 2008.

Inspection team

Two Inspector’s and a member of the medicines team carried out the inspection visits and an Expert by Experience made phone calls to people’s relatives. 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 their own homes and ‘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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 27 September 2022 and ended on 07 October 2022. We visited the location’s office on 27 and 29 September 2022.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority service improvement and safeguarding teams 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 four people and seven relatives about the care and support provided. We reviewed a range of records. This included seven people’s care records and 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 training, audits and staff meeting records were reviewed. We received feedback from seven professionals that were involved with people using the service.

Updated 18 November 2022

About the service

Crimson Hill Support is a supported living and domiciliary care service which provides support to people in their own homes. The service provides support to people with a learning disability and/or autistic people in Somerset. They also provide a respite ‘short stay’ service for people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection 13 people were receiving personal care.

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

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.

Right Support

People had plans in place to guide staff on how to support them if they became anxious or upset, the plans were not always regularly reviewed or updated. Records demonstrated staff were not always using appropriate restraint on people. The service recorded when staff restrained people, improvements were needed to ensure staff learned from those incidents and how they might be avoided or reduced. 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 fully support this practice. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. People were able to pursue their chosen interests.

Right Care

Staff were aware of the signs of abuse and they were aware of how to report any concerns through the appropriate channels. 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. Staff promoted equality and diversity in their support for people. Improvements were required to ensure risks to people were fully assessed and mitigated.

Right Culture

The systems to monitor the quality of the service were not fully effective in ensuring shortfalls were identified and actioned. Staff turnover had been high, which meant people were supported by agency staff, this was improving. Staff understood people well and were responsive to their needs.

People and those important to them, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Staff valued and acted upon people’s views.

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 good (published 04 April 2018).

Why we inspected

We received concerns in relation to safeguarding. During the inspection we identified safeguarding concerns relating to the use of restraint. You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Crimson Hill Support on our website at www.cqc.org.uk.

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.