Purple Flower Care

Updated 15 December 2022

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.

Inspection team

The inspection team consisted of 2 inspectors and an assistant inspector.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 22 September 2022 and ended on 06 October 2022. We visited the location’s office on 22 September 2022.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with the service. Due to technical problems, the provider was not able to complete a Provider Information Return (PIR). A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the person who used the service about their experience of the care provided. We spoke with 6 members of staff including the registered manager, the nominated individual, and support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. These included the person’s care records and medication records. We looked at 5 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. We spoke with 3 people who knew or had worked with the person about the care they received.

Updated 15 December 2022

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

Purple Flower Care is a supported living service providing the regulated activity of personal care. The service provides support to people with learning disabilities or autistic spectrum disorder and people with mental health diagnoses. At the time of our inspection there was one person using the service.

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

Right Support

Although we found no evidence the person had been harmed, we saw some risks had not been effectively shared with the staff team. We found some risks had not been fully assessed to mitigate against avoidable harm. We found the person was subject to some restrictions which had not been subject to best interests’ decisions. Staff had not fully consulted significant people in the person’s life to ensure they were following least restrictive practices. A mental capacity assessment had not been completed to determine what decisions the person could and could not make for themselves. Some staff reported a good and supportive induction. One staff member told us they were only provided with one shift with a regular member of staff before supporting the person alone. Staff communicated with the person in a way that met their needs. Staff enabled people to access specialist health support in the community.

Right Care

The initial assessment and care plan for the person had not taken into consideration their sexuality or their cultural needs. Staff could not be sure they were fully supporting the person in the way they wished in these areas. The person’s care plan lacked some important information and updates. There was limited information about the person’s specific goals and how they were progressing with them. There was some evidence the person had been supported to try new experiences, although in the weeks prior to our inspection their activities were not very varied. Staff were kind and compassionate.

Right Culture

There was limited evidence the person and those who were important to them were involved in the development of the care plan. We found checks on the quality of the care provided were not always robust and had not identified many of the concerns we found.

People were not supported to have maximum choice and control of their lives and staff did not 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.

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 29 September 2021, and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about how risk was being managed by the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, 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.

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

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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to how the person’s care needs were assessed and reviewed; lack of assessment and consideration of what decisions the person could and could not make for themselves and the use of restrictive practices; and the standard of checks and oversight of the service to ensure safe and effective care 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.