Background to this inspection
Updated
5 October 2022
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
The Beach 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. The Beach is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was not a registered manager in post.
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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We met and spoke with six people living at the service. We spoke with seven members of staff including the manager, two care staff, four agency workers and the interim Chief Executive Officer (CEO).
We looked at staff support grids for the period 2 July 2022 to 5 August 2022. We looked at two people’s care plans, people’s daily logs and the service’s diary and communication book.
Updated
5 October 2022
About the service
The Beach is a is a residential care home that provides personal care and support for up to 14 autistic people, people with a learning disability or both. At the time of the inspection there were 11 people living at the service.
The service is a two- storey block of flats with a communal area, located overlooking Porth beach in Newquay. The service is part of Spectrum (Devon and Cornwall Autistic Community Trust) which has several services in Cornwall providing care and support for autistic people and/or people with a learning disability.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support 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.
This service was not able to demonstrate consistently how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
Staff were committed to supporting people in line with their preferences. However, this was difficult to achieve because staffing levels were below those identified as necessary to meet people's assessed needs and wishes. Staff supported people to receive their medicines safely and as prescribed and people were enabled to access health and social care support in the community.
Right care:
The language used by staff to describe a person within their care notes and, on occasion, when speaking with us, was disrespectful. This meant people's care was not person-centred and did not promote their dignity. People’s access to activities was limited, both in and out of the service due to staffing levels. Risks associated with people’s care were assessed and included in their support plans. Care records guided staff on the action they were to take to mitigate risks to people and themselves.
Right culture:
The deputy manager and regional manager and staff were clear about their aim of providing person-centred care. They had a good knowledge of the service and understood the needs of people they supported. However, the ability to deliver person-centred care was often hindered due to staffing levels. Appropriate actions had not been taken by the provider to make improvements within the service since our last inspection. The provider worked with the safeguarding team and multidisciplinary teams to support safe care provision.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 7 July 2021). The service remains rated requires improvement.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
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.
The inspection was prompted in part due to concerns received about staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. However, further concerns and risks were identified so a decision was made to carry out a comprehensive inspection to include the key questions effective, caring and responsive.
We have found evidence that the provider needs to make improvements. Please see the safe, caring, effective, responsive 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 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 regulation in staffing, dignity and respect and governance. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.