Background to this inspection
Updated
31 August 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The onsite inspection was completed by 1 inspector, 1 internal Deaf specialist advisor who is a British Sign Language (BSL) user, 2 BSL interpreters and 1 member of the CQC medicine team. An Expert by Experience made telephone calls to relatives during the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Gallaudet Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Gallaudet Home is a care home without nursing care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. The current manager was going through the registration process with CQC. They were registered with CQC following the inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection under the previous provider. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We communicated using BSL with 5 people and carried out a range of observations. We spoke with 5 relatives on the telephone and 6 members of staff including the manager and provider’s representative. We looked at records relating to people including medicine records and care plans. We reviewed a range of systems and records relating to the running of the service including training records, policies, audits and recruitment.
Updated
31 August 2023
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.
About the service
Gallaudet Home is a residential care home providing personal care without nursing for 7 people who were Deaf and had other conditions such as learning disabilities, autism and mental health. The service can support up to 8 people.
People’s experience of using this service and what we found
Right Support
People were supported to spend their time where they liked within the home. Others were regularly accessing the educational facility on site and the local community. However, some people were not always achieving their full potential or quality of life because staff lacked specialist training. Systems and staff knowledge were not always in place to support people who could become distressed.
People were supported to review their care and support with key staff each month. Staff changes had delayed these meetings for some people and as a result, their preferences had not always been supported.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Right Care
People were supported by staff who knew them well. However, their care plans did not always reflect this detailed knowledge to support consistent care.
People’s privacy and dignity was respected. Each person was valued as an individual and their differences and choices celebrated.
Right Culture
The manager was working towards embedding a Deaf culture into the service by ensuring all staff were able to use British Sign Language. Some individual examples were talked through at the inspection. However, the wider Deaf community and resources had not always been considered.
People were not always living empowered lives because staff did not always have the skills or understanding to embed the ‘Right support, right care, right culture’ guidance. The management promoted a caring culture in the service which some compared to a family feel.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 30 June 2021 and this is the first inspection. The last rating for the service under the previous provider was Good (published 11 January 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We have made 2 recommendations about supporting people who can become upset or distressed and the duty of candour.
We have identified a breach in relation to decisions making at this inspection. Please see the action we have told the provider to take at the end of this report.
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.