Homewards Limited - 51 Leonard Road

Updated 2 December 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.

Inspection team

The inspection team included two inspectors and a member of the CQC medicines team.

Service and service type

51 Leonards Road 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 had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service two hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including information received from the local authority.

We did not ask the provider to complete a Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We visited 51 Leonards Road on 25 August 2021. We met with the registered manager, the deputy manager, and three care staff. One of the inspectors returned to the service on 2 September 2021 to spend time understanding peoples’ quality of life.

We reviewed a range of care records, including three people’s care and medicine records. We looked at two staff files in relation to recruitment, staff supervision and training. We reviewed a variety of records relating to the management of the service.

After the inspection

After visiting the service, we continued to collect information from the provider. We also had a phone call with the registered manager and the deputy manager.

We had email and phone contact with two family members and three staff. We sought feedback from professionals who work with the service.

Recording breaches of regulation:

Following up breaches

At our inspection in August 2019, people were put at risk of harm due to gaps in risk assessments and health and safety issues. The provider did not follow safe infection control practices and lacked effective systems to ensure they learnt lessons when things went wrong. This was a breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.

At our inspection in August 2019, the provider did not follow safe recruitment practices and put people at risk of harm. This was a breach of regulation 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 19.

At our inspection in August 2019, the provider did not deploy staff appropriately which put people at risk of harm. This was a breach of regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 18.

At our inspection in August 2019, there was a lack of effective audit systems to ensure the safety and quality of t

Updated 2 December 2021

Homewards Limited – 51 Leonard Road provides accommodation with personal care for up to three people with a learning disability or who are autistic. At the time of this inspection there were three people using the service.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 or autistic people

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

The service could show how they met the principles of Right support, right care, right culture.

Right support:

The model of care and setting maximised people’s choice, control and independence. People’s support was provided in a safe environment which met people's sensory and physical needs. Improvements had been made in response to previous concerns and managers had focused on minimising risks to people living at the service. People received support that met their needs and aspirations. Support focused on people’s quality of life and followed best practice.

Right care:

Care was person-centred. People were supported to be independent and had the freedom to make their own decisions. Their human rights were upheld. Staff respected their cultural needs. People received kind and compassionate care from staff who respected their privacy and dignity. People were supported to maintain links with their family and friends. People took part in meaningful activities which were part of their planned care and support.

Right culture:

There was a calm, enabling atmosphere, where people felt safe. A person said to us, “I am happy, I like it here it’s peaceful.” The ethos, values, attitudes and behaviours of the management and staff ensured people’s needs and quality of life formed the basis of the culture at the service. Managers were visible and communicated well with people, those important to them and staff. The leadership had worked hard to create an open culture where feedback and learning was encouraged.

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.¿

• People were protected from abuse and poor care. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

• People had their communication needs met and information was shared in a way they could understand.

• People’s risks were assessed regularly in a person-centred way, people had opportunities for positive risk taking. People were involved in managing their own risks whenever possible.

• People who had behaviours that could challenge themselves or others had proactive plans in place to reduce the need for restrictive practices. Systems were in place to report and learn from any incidents where restrictive practices were used.

• People’s care and support plans reflected their sensory, cognitive and functioning needs. Staff regularly evaluated the quality of support given, involving the person, their families and other professionals as appropriate.

• People received care and support from trained staff able to meet their needs and wishes. Managers ensured that staff had relevant training, regular supervision and appraisal.

• People and those important to them, including advocates, were actively involved in planning their care. Where needed a multidisciplinary team worked well together to provide the planned care.

• Managers supported staff to meet their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.

• People were supported by staff who understood best practice in relation to learning disability and/or autism.

• Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs. People and those important to them, worked with leaders to develop and improve the service.

Rating at last inspection (and update)

The last rating for this service was inadequate (published 24 October 2019) and there were multiple breaches of regulation. The provider completed an action plan after this inspection to show what they would do and by when to improve.

We carried out an unrated targeted inspection (published 19 September 2020) due to concerns raised by a whistle-blower about lack of activities, reporting of accidents and incidents and food and nutrition. We found no evidence at this time that people were at risk of harm from these concerns.

At this comprehensive inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 24 October 2019. During this inspection, the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this inspection to provide assurance that the service is applying the principles of Right support right care right culture.

At this inspection 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Homewards Limited – 51 Leonard Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.