1 Uppingham Gardens

Updated 30 September 2022

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

This inspection was carried out by two inspectors.

Service and service type

1 Uppingham Gardens 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. 1 Uppingham Gardens 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post. We were also informed that the registered manager was going to stop managing the service and another manager was going to start managing this service. A new manager had commenced in the post at the service two days before the inspection. Both the registered manager and the new manager supported us during our inspection. The paperwork to make these registration changes had been sent to CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Prior to the inspection we looked at all the information we had collected about the service including previous inspection reports and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law. 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 observed the people who use the service and staff interactions and support. We spoke with the registered manager and the new manager and received feedback from four staff. We reviewed a range of records. This included four people’s care records and all people’s medication records. We looked at six staff files in relation to recruitment. A variety of records relating to the management of the service, quality assurance, maintenance and incidents/accidents, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager, the new manager and provider to validate evidence found such as staff information, further training data, premises and quality assurance records. We contacted five relatives of the people who use the service and spoke to two relatives.

Updated 30 September 2022

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.

About the service

1 Uppingham Gardens is a residential care home providing personal care. It can support a maximum of seven people who are diagnosed with learning disabilities or associated needs. The home consists of seven bedrooms with two bathrooms. Communal dining, lounge, kitchen and large gardens enable people to spend quality time together in the two-storey detached property, located in a quiet cul-de-sac. At the time of the inspection seven people were supported at the service.

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

Right Support:

¿ The registered manager did not use safe recruitment procedures to employ staff. There was a risk people could be supported by unsuitable staff putting them at higher risk of harm.

¿ Staff supported people with their medicines in a way that promoted their independence. However, other aspects of medicine management such as record keeping, medicine stock checks and safe storage needed improvement.

¿ The service gave people care and support in a clean and well-furnished environment that met their sensory and physical needs. However, some aspect of premises safety such as maintenance checks, asbestos and water checks and action plan needed improvement.

¿ People had a choice about their living environment and were able to personalise their rooms. People invited us to view their rooms and showed us how they sorted their rooms.

¿ The service and staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.

¿ Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff communicated with people in ways that met their needs.

¿ Staff enabled people to access specialist health and social care support in the community.

¿ Staff supported people and relatives to play an active role in maintaining their own health and wellbeing.

Right Care:

¿ The registered manager did not ensure effective deployment of staff to meet people’s needs and keep them safe.

¿ The registered manager did no ensure safeguarding alerts were raised when needed. Not all staff were up-to-date training on how to recognise and report abuse.

¿ The registered manager did not ensure appropriate and consistent risk assessment, mitigation and review. Staff did not have current information on how they could help people cooperate to assess risks people might face.

¿ People’s care, treatment and support plans did not always reflect their range of needs and support so staff could promote their wellbeing and enjoyment of life.

¿ People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff spoke to people politely giving them time to respond and express their wishes.

Right Culture:

¿ We found the registered manager did not ensure we were notified of reportable events within a reasonable time frame.

¿ The registered manager did not follow their quality assurance policy effectively so they could assess, monitor and mitigate any risks relating to people, the service and others.

¿ The registered manager did not follow and accurately record and keep a copy of all the actions taken as required in the duty of candour regulation when a notifiable safety incident occurred.

¿ Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

¿ Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.

¿ Staff placed people’s wishes, needs and rights at the heart of everything they did.

¿ People and those important to them were involved in planning their care. Staff valued and acted upon people’s views.

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 22 April 2020) and there were breaches of regulations. 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 the provider remained in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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.

We carried out an unannounced comprehensive inspection of this service on 24 February 2020. 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 good governance and notification of other incidents.

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 the same. 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 1 Uppingham Gardens on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to quality assurance; risk management; notification of incidents; record keeping; management of medicine and premises; staff deployment and recruitment, and duty of candour at this inspection. We have made a recommendation about meeting Mental Capacity Act legal framework.

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.