17 October 2023
During an inspection looking at part of the service
Wellfield is a children’s home which is registered for accommodation for people requiring personal or nursing care as well as treatment of disease, disorder, or injury. The service can accommodate two people. The service provides therapeutic psychological support to children and young people with mental ill health and additional needs, such as neuro-developmental disorders.
Ofsted are the lead regulator for services registered as children’s homes, however, the service was not registered with Ofsted at the time of our inspection.
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: Model of Care and setting that maximises people’s choice, control, and independence.
Right Care: Care is person-centred and promotes people’s dignity, privacy, and human rights.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive, and empowered lives.
People’s experience of using this service and what we found
We had continued concerns that the provider had not always taken all reasonable steps to make sure that risk management plans contained sufficient information to support staff in making sure that young people who used the service were kept safe from avoidable harm.
Although records indicated that most medicines had been well managed, there was not enough information to support staff to correctly administer an ‘as and when required’ (PRN) medicine. On occasions when this had been administered, records were not clear why it had been needed.
The way in which safeguarding incidents had been managed had not been consistent and safeguarding referrals that had been made to the local authority did not always contain enough information.
Systems had not been established to make sure that incidents had been reported, investigated, and managed in a way that reduced the risk of similar incidents happening again. This was not in line with the provider’s own policies and procedures.
Although the provider had done a lot of work to update their policies and procedures, we found that important areas, such as information governance, were not covered. In addition, policies and procedures had not always been further updated to reflect the most up to date practice.
The provider had taken action to make some improvements following our last inspection. For example, more effective systems had been introduced to reduce the risk of absconding. Also, training records indicated that all staff had now completed appropriate safeguarding training for adults and children.
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 requires improvement (published 15 July 2022). This service had also been inspected on 1 and 2 June 2023 (published 21 July 2023) as well as 21 to 23 August 2023 (published 31 October 2023), and the service had previous breaches of regulations.
At this inspection, we found the provider remained in breach of regulations.
As this was a targeted inspection, the ratings from the last inspection have remained the same.
Why we inspected
The inspection was prompted in part due to concerns about the effectiveness of the provider’s systems and processes to keep young people who lived at Wellfield safe. A decision was made for us to inspect and examine those risks.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, safeguarding and good governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.