Background to this inspection
Updated
11 September 2021
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the specific concern we had about the use of physical interventions.
Inspection team
This inspection was undertaken by two inspectors, one specialist advisor and two Experts by Experience, who phoned people's relatives. 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
Precious Homes Wembley provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service did not have a manager registered with the Care Quality Commission.
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 had requested information from the provider prior to the inspection and this information was used as part of the inspection plan. 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 seven members of staff including the new manager and the operation manager. We contacted relatives of people receiving care. We were not able to speak to people due to their needs, but we observed care to help us understand the experience of people who could not talk with us. We reviewed a range of records. This included six people's medicines records, five protocols for medicines to be taken 'when required' and behavioural support plans. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
11 September 2021
About the service
Precious Homes Wembley is a supported living service for people with a learning disability or autistic spectrum disorder. It provides personal care for people who live in their own accommodation. At the time of this inspection the service provided care for 10 people.
People’s experience of using this service and what we found
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.
People did not always receive person centred care. Whilst there were measures to promote person-centred care, these were not implemented effectively. This was evident in areas such as medicines management, managing people’s finances, the management of premises and safety of people’s personal spaces. Cumulatively this meant people did not always receive care that met their needs.
People receiving care were at risk of financial harm. Although we have received evidence the provider is making improvements, at the time of this inspection, the provider was the appointee for financial matters relating to a person receiving care. This arrangement was a source of concern to us because providers should not act as financial appointees, unless there is no other practical alternative.
Quality assurance systems had not been used effectively. Whilst the provider carried out audits in relevant areas, we could not be assured of the robustness of the process. For example, although health and safety audits identified shortfalls, action was not taken within a reasonable time either to improve or mitigate risks.
We were reassured by the deployment of the operational manager following our inspection. She had assumed a more enhanced role to manage improvements. We found her to be knowledgeable regarding her responsibilities and possessed a good grasp of changes that were required to make improvements. Following this inspection we received an action plan, which showed some action that had already been taken to make improvements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Precious Homes Wembley on our website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 25 April 2019). At this inspection we found three breaches of regulation.
Why we inspected
We had concerns in relation to how the service was managed in relation to risks to people and overall leadership. 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.
We have found evidence that the provider needs to make improvements. 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.
Enforcement
We have identified breaches in relation to safe care and treatment, safeguarding and governance. 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 return to visit this service at a later date to check compliance.