The Crescent

Updated 11 March 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

The inspection was carried out by one inspector.

Service and service type

The Crescent 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

This inspection was unannounced.

What we did before the inspection

We reviewed information that we had received about the service since the last inspection. We were provided with information from the local authority quality assurance and safeguarding teams and the Police. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all this information to plan our inspection.

During the inspection

We observed three people who were living at the service, some of whom were unable to communicate well verbally or were being supported by visiting health professionals. We spoke with three relatives and six staff members, including the interim home manager, operations director, team leader and two support workers. The registered manager was not available during the inspection.

We reviewed a range of records. This included three people’s care records and multiple medicine records. We looked at two 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 quality assurance records. We spoke with the local authority.

Updated 11 March 2021

About the service

The Crescent is a residential care home that was providing personal care to four people who had a learning disability and/or autism at the time of inspection.

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

The management of people’s medicines was not always carried out effectively. Systems had failed to ensure accurate medicines information was contained in people’s medicines records. There was no evidence people were harmed as a result of this oversight.

The locations fire risk assessments did not include the environmental recommendations, or any preventative changes completed as advised by the Fire and Rescue Service report.

Staff training was not always completed within timescales to ensure all staff have the necessary and up to date knowledge and skills to support people’s needs and safety.

The systems used by the provider to have oversight of the service were not always followed at the location to ensure accurate and robust quality monitoring was taking place or being completed consistently.

People felt safe and their freedoms were respected. Relatives shared positive views around people’s safety and staff understood people’s needs and how to raise concerns about people’s safety.

People’s needs and independence were promoted by staff and the management team. The provider understood their legal responsibilities in the safety and care of people. The provider was working in partnership with the local authority to make improvements to safety at the service and people’s experiences of care.

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.

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 able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The size and design of the service allows people’s privacy and dignity to be maintained and facilitates person centred care. The service did not feel impersonal and people could choose to use communal areas. The service is located within the local community, close to local amenities and health services. The service recognised people’s strengths, promoted people’s independence and used positive behaviour support to inform their 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 16 April 2019).

Why we inspected

We received concerns in relation to the safe care and treatment of people living at the service, the leadership at the service and the oversight of the service by the provider. As a result, we undertook a focused inspection to review the key questions of safe 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 coronavirus and other infection outbreaks effectively.

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 have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full 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. If we receive any concerning information we may inspect sooner.