Community Places

Updated 1 April 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

Two inspectors and an Expert by Experience carried out 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. The Expert by Experience telephoned people’s families and had discussions about the quality of care.

Service and service type

Community Places 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. Community Places is a care home without nursing care. 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 Care Quality Commission 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. A new manager had been in post for 3 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 21 November 2022 and ended on 16 December 2022. We visited the service on 21 November 2022 and 30 November 2022.

What we did before the inspection

We reviewed information we received about the service since the last inspection We asked for feedback and information about the service from the Local Authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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. We used all this information to plan our inspection.

During the inspection

We spoke to 11 family members of people who lived in the home about their experiences of care and support. We spoke to 4 support workers. We walked around the home and looked in people’s bedrooms, bathrooms, kitchens and communal areas. We reviewed medicines, care plans, staff recruitment files and incident management forms. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 1 April 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

Community Places provides care and support to people with a learning disability or autistic people. Community Places is home to 12 people. At the time of inspection 10 people live in the main building and 2 people live in the bungalow. The service can support up to 16 people.

People’s experience of using this service and what we found

Right Support:

Not all risks were assessed to keep people safe and we asked the manager to complete risk assessments for window restrictors and a profiling bed with bed rails immediately after the inspection. There were enough staff available to support people with their daily routines and activities.

Right Care:

Medicines were not managed safely and there were errors in administration of medication, stock counts and MAR sheets. Infection prevention and control was not managed effectively. Staff had training on how to recognise and report abuse and how to protect people from poor care. The service worked well with other agencies to keep people safe.

Right Culture:

Staff did not always talk with people effectively to find out what activities they might want to do. Accident and Incident forms were not reviewed in a timely manner and common themes from these forms did not improve or change practice. The service was working within the principles of the Mental Capacity Act. The manager and the provider had a clear vision for the development of the service so that people can achieve the best outcomes possible.

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 3 October 2018).

Why we inspected

We received concerns in relation to people being secluded which prompted us to carry out a focused inspection. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led. We found no evidence that seclusion had ever been used in this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements.

Please see the safe, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. The provider has taken action to mitigate the identified risks and we have requested regular updates on these actions from the provider.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Community Places on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to management of medicines, assessment of risks and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We requested 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.