Templefields

Updated 14 January 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 4 December 2020 and was announced.

Updated 14 January 2021

About the service

Templefields is a residential care home providing personal and nursing care to people with autism and/or learning disabilities and associated challenging behaviours. The service is registered to provide support to up to 14 people and there were 12 people using the service at the time of our inspection. People live in either the main house or coach house and the property is situated on the outskirts of Dewsbury.

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

There had been a lack of leadership and oversight at the service which had led to a deterioration in the quality of care and people’s experience of living in the home. The provider had access to a range of specialist support to support people to live fulfilling, although this help had not always been identified as required.

Restraint was used at the service as a last resort and when all other measures had been considered. Records did not adequately analyse incidents where restraint had been used. More detailed records of all behaviours that challenged were needed to ensure the effectiveness of and achieve positive outcomes for people and for staff.

We looked at how the service managed risks to people and found some improvements were required in how the service assessed and managed risk. Recorded risk reduction measures were often generalised and did not show the necessary control measures were in place.

Medicine management procedures were in place. There was no evidence to confirm all staff medication training was up to date and their competency levels checked. The provider identified this and addressed by their own processes. Some staff training was out of date and this impacted on the quality of care provided.

Staff understood people with capacity had the right to make their own decisions. Some mental capacity assessments were not decision specific and best interest decisions processes didn't follow best practice. We have made a recommendation the provider considers current guidance on Mental Capacity Act (MCA) and best interest decision making.

The service applied some of 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. The outcomes for some people did not fully reflect the principles and values of Registering the Right Support for the following reasons: not everyone had choice and control, and this was often limited through the actions of other people living there. Concerns had not been appropriately managed by management to ensure restrictions were limited.

Staff were very dedicated and committed to people at the service. Some said they spent more time at the home than with their own family and they genuinely cared about people. We saw some great rapport with people they supported during the onsite visit and how some staff talked about the people they cared for. However, lack of oversight had led to some areas of care becoming less personalised, but once recognised, the provider put in resources to address these issues. They implemented systems to support staff to ensure they provided the best of care to people and achieved positive 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 good (published 6 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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. 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 breaches in relation to safeguarding service users from abuse and improper treatment, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. We met with the provider several times during this inspection to discuss our concerns. The provider has sent us an action plan and regular updates to demonstrate how they are actively making improvements at the service. If we receive any concerning information we may inspect sooner