24 June 2021
During an inspection looking at part of the service
About the service
Eldertree Lodge is an independent hospital and as part of their registration with the Care Quality Commission they also operate a supported living service called Oakwood House. Oakwood House provides personal care to seven people with learning disabilities, autism and/or mental health needs, who want to live in the community. People living at Oakwood House have a tenancy agreement in place for their accommodation.
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.
People’s experience of using this service and what we found
Risks to people’s safety were assessed but the actions needed to keep people safe were not always present. Legal authorisations for the use of restricitve practice were missing and guidance was not always clear about what people could or could not do. This meant people were at risk of being unlawfully restricted. Accident and incident forms were not always reviewed although plans were underway to ensure this happened.
The provider did not carry out the necessary checks made to visitors, because of the COVID-19 pandemic, and staff did not always wear their face masks, as directed in the guidance.
The governance systems in place had not been effective at monitoring people’s care. There had been a lack of oversight from the provider which meant a care plans had not been updated and some staff had felt forgotten. The provider acknowledged this and shared their action plan for making improvments and who was going to be responsible.
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 statutory guidance which supports CQC 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.
Right support: Oakwood House was set up with the support of local commissioners and offers people bespoke packages of care in the community. However, amendments were needed to people’s care plans to demonstrate how people were being enabled to have maximum choice and control over their lives.
Right care: People did have a personalised package of care. However, the provider was not yet able to demonstrate how they were ensuring people’s human rights were maintained alongside a number of restrictive practices being in place.
Right culture: The service had recently gone through several changes, including a change of leadership. More time will be required to assess whether the leadership in place ensures people have 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 regulated activity of personal care being provided at Oakwood House is part of the registration of Eldertree Lodge. Eldertree Lodge has recently been inspected and is rated as Inadequate. Please see our website for the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This inspection was carried out following concerns raised at Eldertree Lodge. We undertook this targeted inspection to review how risk was being managed and the effectiveness of the governance systems in place. We also looked at infection prevention and control measures under the safe key question. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Enforcement
Enforcement action has not been proposed for Oakwood House. However, enforcement action was taken following our inspection of Eldertree Lodge. Please see our website for the full report which is on our CQC website at www.cqc.org.uk
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.