About the service Hope House is a residential service providing personal and nursing care to 11 people with a learning disability. At the time of the inspection there were eight people living at the service.
Hope House provides accommodation across two buildings with a variety of self contained flats, bedrooms and communal areas.
People’s experience of using this service and what we found
Infection control processes were not embedded and staff didn’t always follow government guidance. Medicines were managed safely. Processes to safeguard people from abuse were followed and risks were effectively reviewed and managed. Staffing levels were safe and the service was working on a recruitment and retention plan to reduce the current high levels of agency staff at the home.
The service was working to ensure recording systems promoted a person centred approach. There was a new management team at the service and staff we spoke with felt they could raise issues and concerns with them. Feedback from relatives was positive relating to the care and support their loved ones received.
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 not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Language used in the provider's care record templates and quality monitoring audit referred to a medical model of care that did not reflect the community residential model being provided.
Right support:
• Model of care and setting maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
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 20 July 2019).
Why we inspected
The inspection was prompted in part due to concerns received about infection control practices and staffing levels. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hope House on our website at www.cqc.org.uk.
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 have identified breaches in relation to infection control and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.