Archived: Bunbury Road

Updated 13 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 16 February 2018 and was unannounced. This inspection was prompted in part due to information of concern shared with us by the local authority. This was in relation to an allegation of abuse. We shared the concerns of the local authority of the provider’s poor and delayed response to this allegation. We ensured this information was shared with relevant partner agencies such as the police and as a result this inspection did not examine the circumstances of the incident. The information shared with CQC indicated potential concerns about the management of risk, and how the provider safeguarded people from the risk of harm and abuse. We examined those risks during our inspection and were not assured appropriate action was always taken to protect people. We identified a breach of regulations and have taken enforcement action in relation to this.

The inspection was conducted by an inspector and a specialist advisor. A specialist advisor is a professional with current practice knowledge and expertise who assists our inspections. As part of our inspection planning, we reviewed the information we already held about the provider. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. Providers are also required to notify the Care Quality Commission about specific events and incidents that occur at the service, such as any safeguarding matters or serious injuries to people using the service. These help us to plan our inspection. As part of our inspection, we spoke with a member of the commissioning team and contacted the local Healthwatch to seek their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During our visit, we spoke with two people, the service project lead, a deputy manager and the registered manager. The service project lead was based at the service and responsible for directly supporting people and staff. The registered manager and deputy manager had some oversight and management of the service along with the provider’s other registered services. We observed a staff handover and the support of another person using the service. During and following our inspection, we also sampled records relating to health and safety, staffing and quality assurance. We spoke with a social worker involved in one person’s care and support. We sampled three people’s support and medicines records and two staff files.

Updated 13 October 2018

This inspection took place on 16 February 2018 and was unannounced. We last inspected this service in January 2017 and it was rated Requires Improvement overall. At this inspection we identified several concerns and found further improvements were still required. The service was rated ‘Requires Improvement’ overall for the second time. We met with the provider in April 2018 to discuss how they would address our concerns, such as their response to safeguarding matters and ensuring safe medicines management. We identified three breaches of the regulations, and we have served a notice of decision for breaches of Regulations 13 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches relate to the provider’s safeguarding policies and processes and their governance. The notice of decision served, requires the provider to provide a monthly report to the Commission outlining their review of those concerns, remedial action taken and an action plan to meet the regulations to ensure the quality and safety of the service. We also identified a breach of Regulation 18 of the Health and Social Care 2008 (Registration) Regulations 2009. We are deciding our regulatory response to this and will issue a supplementary report once our decision is made.

Bunbury Road is a respite service offering accommodation and support for a maximum of five female service users with mental health support needs. At the time of our inspection, three people were using the service. There was a registered manager in place who was present during our inspection. 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.

This inspection was prompted in part by information of concern shared with us by the local authority. This was in relation to the provider’s poor and delayed response to an allegation of sexual abuse. We ensured this information was shared with relevant partner agencies such as the police and as a result this inspection did not examine the circumstances of the incident. However, this information and our inspection findings identified concerns around how incidents and safeguarding matters were responded to. Although two people we met told us they felt safe and safeguarding training was being refreshed, systems did not protect people using the service from abuse because incidents had not been fully investigated. Actions had not been taken as a result such as referrals to relevant partner agencies as required.

We identified breaches of the regulations because risks and incidents were not appropriately recorded or responded to in order to protect people and ensure the safety of the service. Quality assurance processes did not always effectively monitor and improve the safety of the service. Planned improvements had not always been made or processes followed as planned. Some findings reflected a positive and person-centred culture including the approach of staff and the service project lead’s ongoing improvement plans.

Although one person told us they were happy with their medicines support, some issues identified at our last inspection had still not been fully addressed to ensure people received their medicines safely. People told us they had felt more settled over their time at the service due to improved health. People’s needs were monitored and referred to community health teams by staff as needed. Systems were in place to support safe recruitment practice.

Incidents and risks were not routinely discussed with staff, records relating to people’s support were not always accurate and staff meetings were not held as often as planned. This did not help promote learning or develop staff skills and knowledge for their roles. Staff had not received all mandatory training and this was still underway since the last inspection. People were satisfied with the support of staff and described their improved health and wellbeing. People were supported to make choices with their meals and with accessing other healthcare services as needed.

People told us staff were kind and caring. Their feedback showed they valued the approach of staff. People had the privacy they needed and their independence was promoted. Systems were in place to involve people in their support plans and monitor their wellbeing. One person told us they felt able to complain and this was encouraged during residents’ meetings.

You can see what action we told the provider to take at the back of this report.