Churchview Care Services (Taunton)

Churchview Care Services (Taunton) is a domiciliary care and supported living service providing personal care to people with learning disabilities and autistic people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection, the service supported 13 people with the regulated activity personal care.

People’s experience of the 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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

Staff enabled people to access specialist health support in the community, however staff did not always follow professional guidance. People received their medicines from trained staff, the recording of people’s medicines needed to be improved.

Right Care

Risks to people were not always fully managed and mitigated. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right Culture

Improvements were needed to make sure there were effective systems to monitor the quality of the service. Staff turnover had been high, which meant people were supported by agency staff. Regular agency staff were booked to ensure they were familiar with people and their needs. The ethos of the service was to provide person-centred care and promote people's independence. People told us they were happy, and they liked the staff supporting them. The management team and provider were open and transparent throughout our inspection. They acted on queries and our feedback throughout the inspection.

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 (08 June 2023).

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 improvements had been made in relation to medicines management and safeguarding. The provider remained in breach of regulation relating to governance, and we identified additional concerns relating to risk management.

Why we inspected

We received concerns in relation to staff not following professional guidance. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 Churchview Care Services (Taunton) on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in regulations relating to risk management and good 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Churchview Care Services (Taunton) is a domiciliary care and supported living service providing personal care to people living in their own homes.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of inspection the service supported 15 people with the regulated activity personal care.

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

Right Support

People were not always supported to have maximum choice and control of their lives; the policies and systems in the service to support this were not effective. The provider did not always demonstrate best practice when assessing people’s mental capacity or supporting decision-making. This meant people's legal rights were not fully protected.

Staff were observed communicating with people in ways that met their needs and supported people to make choices.

Staff enabled people to access specialist health support in the community.

Right Care

People were supported by staff who knew them well and understood their needs. However, care plans and risk assessments were not always comprehensive and up to date. Some risks to people had not been sufficiently assessed and documented in their care records.

People received their medicines from trained staff. However, individual protocols for medicines which were prescribed to be given 'as required' were not always in place, and the provider’s medication policy was not always being followed. This placed people at risk.

Risks in relation to managing people’s finances were not always managed safely. The provider had raised a safeguarding concern and were investigating concerns at the time of the inspection. During the inspection we identified further concerns, and raised a further safeguarding concern with the local authority safeguarding team regarding this. However, it was found not to meet the local authority threshold.

Staff received training in safeguarding vulnerable adults and knew how to recognise and report any indicators of abuse. Staff spoken with said they would be confident to report any concerns about possible abuse or poor practice.

Safe recruitment practices were followed, and suitable induction and ongoing training was in place for staff. Relatives raised concerns regarding staffing levels. The manager provided assurances that people did receive the right amount of support and that current assessed staffing levels were safe.

People felt safe with the staff who supported them. We observed good interactions between people using the service and staff. Some relatives raised concerns regarding the safety of the support their loved ones received.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Throughout the inspection we observed kind, relaxed, compassionate and caring interactions between people and staff. Relatives told us, “I think the staff work really hard” and “The staff are really good and caring.”

Right Culture

Improvements were needed to make sure there were effective systems to monitor the quality of the service and plan improvements.

The ethos of the service was to provide person-centred care and promote people's independence. Throughout the inspection we observed that staff were respectful of people and took time to offer support and reassurance when needed. One relative told us and there is always a happy atmosphere within the service where their loved one lives.

People told us they were pleased with the support that staff provided to them, although relatives raised some concerns about the service their loved ones received. During the inspection we raised a safeguarding concern with the local authority safeguarding team regarding this.

The management team were open and transparent throughout our inspection. They acted on queries and our feedback throughout the inspection.

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 good (published 29 May 2019.)

Why we inspected

This inspection was prompted by a review of the information we held about this service and information we received from the provider about how people were supported to manage their personal finance. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 Churchview Care Services (Taunton) on our website at www.cqc.org.uk.

Enforcement

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. We have identified breaches of regulations in relation to safeguarding, risk management, consent and quality monitoring and planning improvements.

You can see what action we have asked the provider to take at the end of this full 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

People were happy with the service they received. People told us staff were reliable and always turned up on time or informed them if they were running late.

People were supported by staff who were well trained, kind and caring.

People received their care from a small team of staff who they had been able to build trusting relationships with. People told us they always saw the same staff and this enabled them to feel comfortable and relaxed.

People said staff encouraged them to maintain their independence and were respectful when they helped them. One person said, “They have given me the confidence to be independent.”

The agency organised social events to protect people from social isolation, help them to maintain contact with friends and family and to meet new people. Social events and outings were very much appreciated by people. One person told us, “The social stuff is great. I’ve been to the cinema and the pantomime. It’s good to meet new people.”

People were fully involved in planning their care and staff helped them to fulfil their goals. Staff knew people well which enabled them to provide care and support which was personalised to each person and took account of their wishes.

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 practice. People only received care with their consent and felt they remained in charge of their lives. Staff knew how to support people if they did not have the capacity to make decisions.

People received care from an agency who monitored quality and sought their views. The management was open and approachable which enabled people and staff to share concerns or make suggestions.

Rating at last inspection: This is the first inspection of the service since it was registered to the current provider in May 2018.

Why we inspected: This was a scheduled/planned inspection based on date of registration

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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