Paul Clarke Home

Paul Clarke Home is a residential care home, providing accommodation and personal care. This service supported people with learning disabilities and/or autism. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Eight people were using the service at the time of the inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. Accommodation was provided in one residential house with a garden.

People’s experience of using this service

Systems were not always effective at identifying areas for improvement. Checks on the building were not always effective. Action was taken following feedback, but this was largely prompted by the inspection. An action plan in place had failed to fully encompass all areas for improvement. One notification had not been submitted to us, as necessary.

People did not always have their mental capacity assessed when needed, decisions made in people’s best interest were not always recorded and one person did not have a Deprivation of Liberty Safeguards application made which put them at risk. The décor of the home was suitable for people living there, although building checks were not always effective. People were supported to have food and drinks of their choice, although we observed one person was not always being supported in line with their eating risks. People had their needs assessed. Improvements were made to weight monitoring following our feedback. Staff received training to be effective in their role. People had access to other health professionals and staff were kept up to date with changes in people’s care in handovers.

There were enough safely-recruited staff to support people. People were kept safe as risks were assessed and planned for and staff were aware of these. Staff understood their responsibilities to safeguarding people, report concerns and knew how to report them. People were supported to have their medicines as prescribed. Infection control measures were in place so people were protected. Lessons were learned when things had gone wrong, accidents and incidents were reviewed and the provider had recognised they could get additional support from an external consultant.

People were supported in line with Registering the Right Support; they were supported to make decisions and be independent. People were supported by a kind and caring staff team who knew them well. People had their dignity and privacy maintained.

People were supported in a way they liked and had personalised care plans in place to guide staff. People could partake in activities of their choice and could access the community. People were supported to communicate in a way that met their needs. Complaints were investigated and responded to. No one was needing end of life care at the time of the inspection, but the provider was aware of their responsibilities to support people.

People and staff were positive about the provider and staff team. The provider was clear about their responsibility about duty of candour and the previous inspection rating was being displayed, as necessary. People and staff were engaged in the service. A new charter had been introduced to support people in line with their human rights and to make it a fun place to live and work. The service worked in partnership with other organisations to support people.

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 1 March 2019). We had found breaches of regulation in relation to governance and submitting notifications. At this inspection enough, improvement had not been made or sustained and the provider was still in breach of regulations and we found an additional breach about consent.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to consent, governance and the submission of notifications. 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 as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Paul Clarke Home is a residential care home, providing accommodation and personal care. This service supported people with learning disabilities and/or autism. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Seven people were living at the service though one was in hospital at the time of the inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. Accommodation was provided in one residential house with a garden.

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support. 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.

Improvements were required to systems and processes in place to ensure that quality and safety was monitored and any areas for improvements were identified and acted on swiftly.

Staff knew the people that lived at the home well and knew how to safely meet their needs. However, there were gaps in staff training and the provider had not monitored this effectively or acted swiftly to ensure the right training was available to staff. Staff did feel well supported and had access to regular supervision and support.

We have made a recommendation about recruitment procedures.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.

People’s independence was supported and encouraged.

People felt safe and happy. They had choices and were supported to communicate effectively and express their views, which were listened to. Staff knew people well and catered for their preferences. Care plans were personalised and gave staff the information they needed to safely meet people’s needs.

Staff treated people with kindness and there was a positive, inclusive atmosphere in the home. People and staff had good relationships.

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

Rating at last inspection: This is the first time the service has been inspected under this registration.

Why we inspected: This was a scheduled inspection based on the time since the service first registered with us.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will seek an action plan from the provider to show us how they will become compliant and by when. We will continue to monitor the service and inspect again within 12 months of the publication of this report.