Background to this inspection
Updated
18 October 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Inshore Support LTD – 10 Beeches Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission. This means the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
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. 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
One person who lived in the home did not wish to speak with us. Due to communication needs the other person was not able to speak with us. We spoke with five members of staff including senior care workers and care workers. The deputy manager was not at work on the day of inspection, so we spoke with the director of care and the care services manager.
We reviewed a range of records. This included two people’s care records and medication records. We looked at two 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.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with two relatives about their experience of the service.
Updated
18 October 2019
About the service
Inshore Support LTD – 10 Beeches Road is a residential care home providing accommodation for people who require nursing or personal care and have a diagnosis of a learning disabilities and autistic spectrum disorder. The service can support up to two people and two people were receiving support at the time of the inspection.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the management team at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
People’s experience of using this service and what we found
Audits were not robust enough to demonstrate safety was effectively managed. There was no registered manager in post, the deputy manager was overseeing the day to day running of the home. Staff felt well supported and part of a team. Staff worked in a person-centred way.
Relatives felt their loved ones were safe. Some staff told us they did not always follow care plans. Information relating to people’s allergies was not reflected in all documentation. Medicines were not always dispensed in line with best practice guidelines. Staff understood safeguarding and how to keep people safe.
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.
Peoples dignity was not always maintained. People were encouraged to maintain their independence. Relatives felt their loved ones were treated with kindness. People information was stored securely, and confidentiality was maintained.
Peoples communication needs were met, and information was provided to people in different formats. Peoples personal preferences were identified in their care plans. People were supported to maintain relationships.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
The service applied the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected the principles and values of Registering the Right Support and focused on them having as many opportunities as possible. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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 29 March 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to failure to meet a condition of registration and good governance 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 request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.