The Crown

Updated 2 December 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 1 inspector.

Service and service type

The Crown 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 Crown 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, a new manager had been recruited and submitted an application to register. We are currently assessing this application.

Notice of inspection

We carried out 2 visits to the service. Both were unannounced and took place over an evening and a weekend.

What we did before the 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.

We used all this information to plan our inspection.

During the inspection

We spoke with, and observed the support provided to, both people living at the service; to understand more about their experience of the care provided.

We spoke with 1 relative and 7 members of staff including: the nominated individual, the new manager, 1 senior support worker and 4 support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records including care, risk management and medicine records for both people using the service. We also looked at a variety of records relating to the management of the service, including policies and procedures, staff files in relation to recruitment and staff supervision, audits, and meeting minutes. Review of this information allowed us to corroborate our findings, and ensure the care and support provided to people was appropriate for them.

Updated 2 December 2023

About the service

The Crown is a residential care home which can accommodate up to 7 adults who have a learning disability and / or autistic people. At the time of this inspection there were 2 people living at the service.

The accommodation is arranged over 3 floors and includes shared living and kitchen areas, with 7 individual bedrooms - each with their own ensuite and kitchenette facilities. Of these, 3 have been designed for people with additional physical disabilities. Accessibility is further promoted through the inclusion of a passenger lift and accessible outside space, including an enclosed garden and parking on site.

People’s experience of the service and what we found:

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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

We found areas requiring improvement such as: reporting potential safeguarding concerns to the relevant authorities, increasing staff awareness regarding CQC inspections and access, the quality and safe storage of records and quality assurance processes; which focused more on systems and processes, rather than people’s lived experience and quality of life.

The provider had installed CCTV in communal areas of the service however, they had not consulted with people living at the service or gained their consent to being filmed. This meant people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

Despite this, a new manager was in post who demonstrated a strong commitment to improve the service and address all the inspection findings as quickly as possible. They made a number of changes before the inspection finished but these were too recent for us to assess the effectiveness of all the actions taken on this occasion.

Staff helped people to stay safe by managing known risks, such as falls and seizures. People were protected from the risk of infection because they lived in a clean, tidy environment.

Staff understood how to support people if they became distressed. They were kind, patient and respectful towards people at all times. Staff consistently followed agreed support plans to refocus people and ensure people’s behaviour was not controlled by excessive or inappropriate use of medication.

There were enough staff to spend quality time with people, as well as meeting their essential needs. However, plans sometimes needed to be made in advance to ensure there were always enough staff to enable people to have a bath, or go out if they wished to do so.

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 10 January 2020).

The service went through a period of dormancy (when it was closed) from December 2020 until October 2022.

The overall rating has changed to Requires Improvement, based on the findings of this inspection.

Why we inspected

The inspection was prompted in part due to concerns received about personal care, medicines, risk management, recording and reporting safeguarding concerns, and staffing levels.

We undertook a focused inspection to review the key questions of Safe and Well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for The Crown on our website at www.cqc.org.uk.

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.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.