Background to this inspection
Updated
24 February 2022
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.
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.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
Selborne Mews 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 is required to have a registered manager. However, there was no manager registered with the Care Quality Commission at the time of our inspection. The service had a peripatetic manager who we refer to in this report as the interim manager. The provider told us a new manager has been appointed but they had not yet commenced their role when we inspected. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service. We sought feedback from the local authority. We did not ask the provider to complete an 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
We spoke with seven staff, including care staff, team leaders and the interim manager. We met eight people, observed their care and sought their views. We reviewed a range of records. This included four people’s care records. We looked at two staff files in relation to recruitment. We also looked at a variety of records relating to the management and quality assurance of the service.
After the inspection
We spoke with two relatives and we looked at further records and continued to seek clarification from the interim manager to validate evidence found.
Updated
24 February 2022
About the service
Selborne Mews is a care home and accommodates up to 20 people with learning disabilities. Some people living at the service were also diagnosed with mental health conditions and had complex support needs.
At the time of our inspection 13 people were living at the service.
People’s experience of using this service and what we found
At our last inspection we found care and treatment was not always provided in a safe way. There was also a lack of provider oversight which meant risks to people’s safety had not always been identified and responded to appropriately.
At this inspection we found that improvements had been made and the breach of safe care and treatment had been met. Improvements had been made to the providers monitoring of the service, but further embedding of the systems and oversight were needed.
Improvements had been made to the physical standards of the service and some further work was needed and the provider had plans in place for this.
Staff understood what action to take if they suspected somebody was being harmed or abused. Incidents and accidents were monitored for future learning. Staff knew people's needs.
There was enough staff on duty to meet people's needs and recruitment processes were in place to safely recruit staff. Vacant posts were being recruited to and contingency plans were in place should these be needed.
People received their medicines when needed. We saw kind interactions with people. Staff felt supported by the interim manager and told us improvements had been made since our last inspection of the service.
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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The service was a large home, bigger than most domestic style properties. However the size of the service having a negative impact on people was mitigated in part by people being provided with individual living accommodation. Some people had been supported to move to a different flat. This had been significant for some people because their new living environment was more suited to their needs, for example it provided a quieter living environment. The use of technology was being introduced for some people to support their communication needs. Reviews of people's needs were also taking place to determine their future plans
The last rating for this service was inadequate (published July 2021).
The service has improved to requires improvement.
Why we inspected
At our last inspection we found a breach of safe care and treatment and also a breach of the providers quality monitoring systems. We imposed a condition which meant the provider was required to tell us each month about the improvements they were making at the service. This inspection took place so we could monitor the improvements the provider told us they had made.
We looked at the safe and well led key questions only. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.
The overall rating for the service has improved to requires improvement. This means the service will no longer be in special measures.
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
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a repeated breach regarding good governance. 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.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Selborne Mews on our website at www.cqc.org.uk.
Follow up
We will work with the 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.