Menna House

Updated 18 May 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 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

Three inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Menna House 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. 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We met with all five people who used the service. Some people who used the service who were unable to talk with us used different ways of communicating including using simple signs and body language.

We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff and the person themselves. In this report, we used this communication tool with one person to tell us their experience.

We spoke with four members of staff including the senior support worker. The expert by experience spoke with five relatives over the telephone.

We reviewed a range of records. This included people’s care records, medication records and one person’s personal money records. We looked at two staff files in relation to recruitment. 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 spoke with the registered manager.

Updated 18 May 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

Menna House is a residential care home providing personal care to five people at the time of the inspection. The service can support up to five people.

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

This service was not able to demonstrate how they were meeting all of the underpinning principles of Right support, right care, right culture.

Right Support

¿ People had identified goals in relation to things they wanted to do and skills they wanted to develop. There was limited evidence to monitor what steps people had taken to achieve these goals and how staff could support them further. This meant opportunities for developing individuals’ skills could be lost.

¿ Parts of the service were poorly maintained and some furniture, fixtures and fittings and soft furnishings were of a poor quality. This had been identified and the registered manager had ordered replacement bedding and towels for people. However, the condition of some of these items showed they had needed replacing for some time and were still in use during the inspection.

¿ People’s bathrooms were not designed to provide a pleasant setting for people when receiving personal care. Some were cramped and all lacked decoration or good condition storage.

¿ Risks related to the premises were not always identified or acted upon.

¿ People were able to personalise their bedrooms. Two people had their own living rooms, so they were able to spend time alone when they wanted to.

¿ Staff supported people to pursue their interests. One room had been developed as a sensory room and was equipped to meet each individuals’ needs.

Right Care

¿ Parts of the environment were not set up in a way which consistently protected people’s privacy and dignity. Following the inspection, the registered manager took steps to make some improvements in this aspect.

¿ Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

¿ The service had enough appropriately skilled staff to provide people with one to one support and keep them safe.

¿ People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right culture

¿ Oversight of the service had failed to recognise where improvements could be made. There was a culture of low expectations for people in relation to their environment and access to good quality household items.

¿ Where it had been identified that improvements were needed, these had not been completed in a timely manner.

¿ Although the registered manager had been made aware of current best practice as described in Right support right care right culture and closed cultures guidance this had not impacted on people’s experiences.

¿ People led busy lives and staff were motivated to support people to get out and take part in things they enjoyed.

¿ People and those important to them, including advocates, were involved in planning their care.

¿ There was a core staff team who had worked at the service for a long time. This meant people got consistent care from staff who knew them well.

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 9 June 2018)

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.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Enforcement

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.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.