About the service The Firs is a supported living service. At the time of our inspection seven people with learning difficulties were using the service.
Not everyone who used the service received personal care, CQC only inspects where people receive personal care. Personal care is support related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The medicines of one person were not kept securely.
Staff spoke negatively about the management of the service and felt unsupported in their roles.
People and their relatives were not consistently involved in the review and development of care plans.
Relatives and professionals linked to the service told us that management were not consistently responding to issues in a timely manner.
Relatives and people told us they felt safe with the staff who supported them.
Staff had regular safeguarding training and knew about the different types of abuse.
Staff understood their responsibilities in relation to protecting people from the risk of harm.
People were supported by staff who were well trained and competent in their role.
People were assessed before they used the service to ensure their needs and preferences could be met.
Staff understood the importance of ensuring people's rights were understood and respected.
People and their relatives told us they felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible.
Where people lacked capacity, 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.
People’s communication needs were assessed and understood by staff. People were provided with information in a format which met their needs.
Staff liaised with other health care professionals to ensure people's safety and meet their health needs.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were working towards consistently meeting the underpinning principles of Right support, right care, right culture.
Right support:
People were supported to be independent and have choice and control. Systems in place were not consistently enabling people to have their voices heard. People were supported to make choices about where they go, what they do and to follow their own interests. People could access the local community and local health services.
Right care:
Care was delivered in a way which meant people's human rights were respected. People had unrestricted access to their home and their own rooms which promoted privacy and dignity. The service worked to ensure that people's human rights were met and supported people to understand they have the same rights and responsibilities as other citizens.
Right culture:
The Firs were working with management and staff at all levels to continually improve the culture of the service. Staff were aware of the organisations visions and values which were centred around supporting people to live meaningful lives. Staff had received specific training to meet the needs of people with a learning disability and spoke passionately about people and the care and support they provided.
The provider confirmed they would make amendments to the care plan review process to ensure people and their relatives were involved in the development of care provided.
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 location was Good (published 27 December 2019).
Why we inspected
We received concerns in relation the management of safeguarding incidents. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe, Effective and Well-Led sections of this full report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
Enforcement
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.
We have identified a breach in relation to safe care and treatment at this inspection. The provider responded to the concerns on the day of the inspection. 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.