Southbank

Southbank is a residential care home providing personal care to up to 13 younger adults and older people with a learning disability and/or autism. Southbank provides people with long-term and short-term care across three bungalows. Each bungalow has its own kitchen, dining and living area, communal bathroom and access to the communal garden. People have their own bedrooms. At the time of the inspection there were 8 people permanently living at the home, and 2 people who was staying at Southbank for a short stay.

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

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.

Right Support

Some were supported to make their own day to day decisions and choices. 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

People's care plans and risk assessments did not always reflect their current needs to consistently promote their wellbeing. However, staff who supported people understood people's needs as they knew them well. Parts of the home required refurbishment, and furnishings needed to be replaced, to promote people's dignity and enjoyment of life. Staff understood people's individual ways of communicating.

Right Culture

There had been changes to the leadership at the home and this had impacted the quality assurance process. The provider was taking steps to improve the governance of the home, but these improvements were not yet fully embedded. The nominated individual visited the home regularly each week, they and the management team spent time listening to people and staff’s views. Visiting professionals felt there were improvements to the communication and people experienced better outcomes.

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 requires improvement, (11/12 October 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made. The provider was no longer in breach of regulation 12, Safe Care and Treatment, however, we found the provider remained in breach of regulation 17, Good Governance.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 11/12 October 2023. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 remained requires improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We have identified a breach in relation to the governance of the service.

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.

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

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.

Right Support

Some people were supported to make their own day to day decisions and choices, however, we found instances where staff did not always empower people to do this. People and relatives were not always supported to be involved in planning people’s care.

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

People’s care plans and risk assessments did not always reflect their current needs and did not consistently promote their wellbeing. Staff understood people’s needs but did not always ensure care was delivered in a safe and effective way. This placed people at risk of harm. Parts of the home required refurbishment, and furnishings needed to be replaced, to promote people’s dignity and enjoyment of life. Staff understood people’s individual ways of communicating.

Right Culture

People did not always lead inclusive and empowered lives because the systems and processes to monitor the culture of the service had not always been effective. There had been changes to the leadership at the home and quality assurance process. This meant people’s wishes, needs and rights were not always at the heart of how the home and service was managed. The provider was taking steps to improve the governance of the home, but these improvements were not yet fully embedded.

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 21 April 2022 and this was the first inspection.

The last rating for the service under the previous provider was requires improvement, published on 11 January 2020. The service remains rated requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about management of medicines, staffing levels and people’s care needs not being met. There were also concerns people were at increased risk of harm because staff were not guided by up to date information on people’s risk. A decision was made for us to inspect and examine those risks.

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 have identified breaches in relation to how people’s safety is managed, and how the home and service is run at this inspection.

You can see what action we have asked the provider to take at the end of this full 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.