Background to this inspection
Updated
19 January 2023
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 Health and Social Care Act 2008.
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
The inspection was completed by one inspector
Service and service type
51 The Drive is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. 51 The Drive is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post. However, they left the service on the first day of inspection and told us they were planning on deregistering with CQC.
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 who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 1 person who used the service about their experience of the care provided. We spoke with 7 members of staff including the registered manager, directors, and care workers.
We reviewed a range of records. This included 2 people’s care records and multiple medication records. We looked at 3 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.
Updated
19 January 2023
About the service
51 The Drive is residential care home providing care for to up to 3 people with a diagnosis of learning disabilities, autistic spectrum disorder or mental health needs. At the time of the inspection 2 people were living in the home.
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.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
Right Support:
Risks to people had not always been assessed or mitigated. Risk assessments did not always contain the strategies required to reduce the known risks to people.
Medicine management required improvement. Records were not always kept up to date and staff told us that unsafe medicine practices had occurred.
People’s care plans and risk assessments were not always kept up to date. We found incorrect information recorded and some areas were missing.
People were not always supported to have maximum choice and control of their lives and we could not be assured that staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Right Care:
The provider had not completed any investigation when people were found with unexplained injuries. Safeguarding procedures had not been consistently followed as unexplained injuries had not always been reported to the local safeguarding team.
Staff did not always have the information required to support people safely and, in a person-centred way. Issues with accessing the electronic care planning system meant at times staff had no access to people’s care plans and risk assessments.
Staff did not always have sufficient training to meet people’s individual needs.
People did not always know the staff, due to high levels of agency staff being deployed. Staff were safely recruited.
Infection prevention and control procedures needed to be followed to protect people from the risks of infection. Cleaning schedules were not consistently recorded as completed.
Right Culture:
Systems and processes were not effective in assessing, monitoring and reducing risks. Where improvements were needed these had not always been identified, due to audits either not being completed or not identifying the issues we found on inspection.
Staff did not consistently feel supported within the workplace.
Information was shared with relevant professionals and significant people. Feedback was sought from people who used the service and their relatives. Feedback was in the process of being reviewed.
The provider was open to feedback and put actions in place to mitigate concerns found on inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was requires improvement (published 6 October 2021) 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 improvements had not been made and the provider still in breach of regulations.
Why we inspected
We received concerns in relation to infection control and risk management. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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.
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 not changed from requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 51 The Drive on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safeguarding, risk management and oversight at this inspection.
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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.