St Leonards Place

Updated 11 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 inspection was carried out by 1 inspector.

Service and service type

St Leonards Place is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. St Leonards Place 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 a registered manager in post. The provider and the registered manager were the same person. We refer to them as registered manager through this report.

Notice of inspection

This inspection was announced. We gave the service short notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 20 June 2023 and ended on 29 June 2023. We visited the location on 20 and 29 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and the 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 gathered as part of monitoring activity that took place on 5 June 2023 to help plan the inspection and inform our judgements. 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 with 2 relatives about their experience of the care provided to their loved ones. We observed the support provided to people within the communal areas. We spoke with 5 staff. This included the registered manager, the new manager, and 3 care staff.

We reviewed a range of records. This included 3 people's care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 11 August 2023

About the service

St Leonards Place is a residential care home, providing accommodation and personal care to 3 people at the time of the inspection. The service can support up to 3 people. The people living in the service had a learning disability and/or autism. Some people were not able to verbally communicate and required full support from staff. One person was more independent and able to manage many areas of their day to day life, going out alone for example.

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

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

People were enabled to make their own choices and express their wishes in their own way and staff understood them. People were encouraged by staff to do the things they could do for themselves.

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.

Right Care:

Although staff knew people well, they were not always provided with sufficient guidance in relation to people’s individual risks. People could not be assured staff were recruited safely as safe recruitment practices were not followed and recruitment procedures were not used effectively.

People were safe with staff as staff had received safeguarding training and recognised potential signs of abuse. Relatives told us their loved ones were safe. People’s medicines were managed safely, staff received appropriate training and had their competency checked in relation to medicines.

Right Culture:

People’s care was not always fully checked for quality and safety as monitoring processes were not robust and effective. The provider had not complied with regulations, they had not submitted notifications to CQC about people being subject to DoLS authorisations.

The provider had established a good culture within the staff team. Most staff had worked at St Leonards Place for many years and told us this was because they felt supported, and they enjoyed their job. Relatives spoke very highly of the registered manager and how well they run the service.

Relatives and staff were involved in the running of the service through surveys and meetings. The provider and manager attended forums in order to learn from other registered providers to help them look for ways to improve.

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 11January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 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.

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

Enforcement

We have identified breaches in relation to the assessment of risk, safe recruitment and good governance.

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.