The Bungalow

Updated 10 February 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 carried out by one inspector.

Service and service type

The Bungalow 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. The registered manager was not available on the day of inspection.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service and the provider since the last inspection. We sought feedback from the local authority. 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 and met the other three people in the home who had limited verbal communication. We spoke with five members of staff including, a peripatetic manager and support workers.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and updated records.

Updated 10 February 2021

About the service

The Bungalow is a small residential care home providing personal care to four people with learning disabilities at the time of the inspection. The service can support four people maximum.

The accommodation is mainly all on the ground floor, with one bedroom and a small lounge area upstairs. People have access to a garden and the home is close to local amenities.

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

People were protected from harm by staff who had been trained in recognising and reporting abuse. Restrictive practices were currently being reviewed by the provider alongside staff confidence to speak up. Staff did not always feel they were listened to but this had improved following some recent changes.

Risks to people’s safety were assessed but improvements were needed in regard to fire safety documentation. Infection and prevention controls were in place. However, some of the identified risks needed further attention. For example, individual staff risk assessments had not been completed.

Systems were in place to ensure lessons were learnt when things went wrong. The processes in place were being reviewed and investigations were underway to establish why some issues had not been highlighted sooner.

People were supported by a sufficient number of staff, although staff felt tired due to having to cover shortfalls in the team. People received their medicine from staff who had received the necessary training.

Plans were in place to increase staff engagement following a noted reduction in staff supervision. The provider was working in partnership with others to make necessary improvements.

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 providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. A closed culture in the home had begun to develop. A closed culture can be described as poor culture where the risk of harm is increased due to a range of different factors such as poor leadership and restrictive practice.

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 1 August 2019).

Why we inspected

We received concerns in relation to the management of the service and the potential for people to be at risk of harm. As a result, we undertook a focused inspection to review the key questions of 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 found no evidence during this inspection that people were at risk of harm. However, we have found evidence that the provider needs to make improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for, The bungalow 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.