Background to this inspection
Updated
24 April 2021
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.
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
This inspection was undertaken by one inspector.
Service and service type
Life Opportunities Trust - 6a Sewells is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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. A 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
This inspection was unannounced.
What we did before 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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with one person who used the service about their experience of the care provided and the deputy manager. We toured the building and observed staff supporting people. We reviewed a range of records. This included medicine records, staff files in relation to recruitment and further records relating to the quality assurance of the service, including accident and incident records.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We reviewed two people's care records and spoke with two members of staff. We also spoke with the local authority commissioning team and safeguarding team.
Updated
24 April 2021
About the service
Life Opportunities Trust – 6a Sewells is a ‘care home’ providing accommodation for up to seven older people with learning disabilities. At the time of the inspection there were six people living at the home.
People's experience of using the service and what we found.
Individual risks were not always assessed or managed to help keep people safe or to ensure that the care provided consistently met their assessed needs.
People who had specific time allocated for one to one activity did not always receive this.
People were referred to health professionals when needed, however the resulting guidance was not always followed by staff.
People, or the management team, could not be assured that new staff were adequately checked to ensure they were suitable to work with people. We found no evidence that people had been harmed however, systems were not robust enough to demonstrate staff recruitment was effectively managed.
People were not supported by staff who had been trained to meet their specific care needs.
Medicines were administered when required but staff did not maintain accurate records.
Audits and checks of the service were not routinely completed. This meant the management team were not aware of concerns identified during this inspection in relation to risk management, recording and governance.
People had regular staff who they knew well and who they felt safe with. One person said, “[Staff name] is my favourite, they are very nice to me and I like it when they are here.” Staff told us they felt there were enough staff to support people safely.
We were assured the service were following safe infection prevention and control procedures to keep people safe.
The service didn’t always apply the principles and values of Registering the Right Support and other best practice guidance. 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. Although this was a focused inspection which meant we only looked at two domains, Safe and Well-led rather than all five domains we did find people did not always receive person-centred care which promoted their dignity, privacy and human rights. People were not always supported to follow their interests and take part in activities in the local community (when there were no COVID-19 restrictions).
The service did not have a registered manager. A lack of oversight of the service by the provider meant we were not assured that people received high quality care and that the provider was committed to continually improving the service.
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 (30 November 2017).
Why we inspected
We received concerns in relation to infection control procedures, managing people’s changing health needs safely, recruitment and overall governance of the service. As a result, we undertook a focused inspection to review the key questions Safe and Well-Led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. 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 Life Opportunities Trust – 6a Sewells on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, in particular risk management and good governance at this inspection.
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 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.