Princes Road Residential Care Home

Princes Road Residential Care Home is a residential care home providing personal care for up to six people. The service provides support to people with a learning disability or autistic people. At the time of our inspection there were five people using the service.

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

Where incidents occurred, the local authority safeguarding team was not always notified in a timely manner. Concerns were raised that there were not always enough staff to manage behaviour that could be considered challenging; and staff had not been trained in this.

A new management team had recently been introduced to the home. Prior to this the home had been lacking in management oversight and support. This has impacted on morale across the home and meant that improvements required had not been addressed quickly. Statutory notifications were not always submitted when important events occurred, and provider management did not have sufficient oversight of safeguarding incidents.

Relatives felt their loved ones were well cared for, that the staff team treated them with dignity and respect. People were supported with their individual needs and their independence was promoted. Where healthcare support was required the service supported people to access the appropriate professional. Advocacy support was accessible to those that required it.

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 statutory guidance which supports CQC 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.

Right Support: Staff supported people to make choices about their day to day lives and be independent in their tasks.

Right care: Staff treated people with dignity and respect, with relatives feeling their loved ones were well cared for.

Right culture: The culture of the home was improving with a new management team that staff, relatives and professionals felt could make a difference.

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 14 August 2019)

Why we inspected

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

The inspection was prompted in part due to concerns received about Deprivation of Liberty Safeguards (DoLS) conditions compliance, oversight and management, staffing levels, activities and responding to behaviours that could be considered challenging. A decision was made for us to inspect and examine those risks.

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.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Princes Road Residential Home on our website at www.cqc.org.uk.

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.

Enforcement and Recommendations

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.

We have identified breaches in relation to safeguarding people from abuse and improper treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Princes Road is a care home providing care and support for up to six people with learning disabilities. The home is managed by Certitude Support for Living Limited and is situated in the Hampton area within the London Borough of Richmond Upon Thames. There were no vacancies.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The home was a safe place for people to live and work in. People enjoyed living at Princes Road. Any risks to them were assessed, enabling them to live safely and enjoy their lives, whilst taking acceptable risks. The home reported, investigated and recorded accidents and incidents and safeguarding concerns. There were suitable numbers of appropriately recruited staff. Medicine was safely administered.

People were not discriminated against and their equality and diversity needs met. People were spoken to in a clear way by staff, who were well-trained, supervised, and appraised. Staff encouraged people to discuss their health needs and people had access to community-based health care professionals. People were protected, by staff, from nutrition and hydration risks and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences. The premises were adapted to people’s needs. Transition between services was based on people’s needs and best interests.

The home’s atmosphere was warm, friendly and welcoming with people enjoying the way staff provided them with care and support. The staff we met were caring and compassionate. There were positive interactions between people, staff and each-other during our visit. Staff observed people’s privacy, dignity and confidentiality. People were encouraged and supported to be independent and had access to advocates.

People received person centred care having had their needs assessed and reviewed. They had choices, followed their interests and hobbies and did not suffer social isolation. People were given information to make decisions and end of life wishes were identified. Complaints were recorded and investigated.

The home’s culture was open, positive and honest with transparent management and leadership. There was a clear organisational vision and values. Areas of responsibility and accountability were identified, and service quality frequently reviewed. Audits were carried out and records kept up to date. Good community links and working partnerships were established. Registration requirements were met.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 13 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The home provides care and accommodation for up to six people with learning disabilities. It is located in the Fulwell area of Twickenham.

At the time of our inspection the home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

This was the first inspection with a new provider.

People told us they enjoyed living at Princes Road and that it was their home. They also thought that staff provided them with the care and support they needed. People decided what activities they wanted to pursue and when they wished to do them. People also felt safe living at the home and doing activities within the local community. The home provided a warm, friendly and welcoming environment with people coming from and going to activities as they wished and being under no pressure to do things they did not wish to. Their body language and interaction was also very positive towards staff and each other. They had a wide variety of activities to choose from at home and in the community.

People's care records were readily accessible, up to date and covered all aspects of the care and support people received, their choices, activities and safety. People’s care plans were completed and the information contained was regularly reviewed. This meant staff were able to perform their duties efficiently and professionally. People were encouraged by staff to discuss their health needs and had access to GP’s and other community based health professionals, as required. People were supported to choose nutritious, balanced meals to promote a healthy diet that also met their likes, dislikes and preferences. This enabled them to be protected from nutrition and hydration associated risks. People said they enjoyed the meals they ate.

People were familiar with who the staff that supported them were, said they liked them and the staff also knew people who use the service and their likes and dislikes. People were well supported and they enjoyed how staff delivered their care. People were provided with information about any activities taking place so they could decide if they wanted to participate. Staff provided care and support in a professional, friendly and supportive manner that focussed on people as individuals. Staff had appropriate skills to carry out their roles, were well trained and made themselves accessible to people using the service. Staff told us they enjoyed working at the home and felt well trained and supported by the manager and organisation.

People said the manager and staff were approachable, responsive and listened to them. The quality of the service provided was consistently monitored and assessed.