Bloomberg Care Services Ltd

People using the service lived in a semi-detached house, with shared kitchen and bathroom facilities.

People’s experience of using the service

The provider's recruitment practice had not always been effective and improvements were required.

The provider had made improvements to the systems in place to monitor the quality and safety of the service and these now needed to be embedded.

Staff knew how to report accidents and incidents and learning from these took place. Arrangements were in place to ensure that all staff would receive the required physical intervention training which will include de-escalation techniques.

Infection control guidance was in place. People had risk assessments in place including risks related to the COVID -19 pandemic.

People were supported by staff who knew their needs. Staff understood what action to take if they suspected somebody was being harmed or abused. Medicines were managed safely.

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 guidance CQC follows 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 some of the underpinning principles of Right support, right care, right culture. Granville Drive looked like a family home and there were no identifying external signs to indicate the house was a care home. People had been supported to personalise their rooms. The home was within easy access of local amenities which people were supported to access. The atmosphere in the home was welcoming and calm. Accessible information was used to support people’s understanding and engagement.

Rating at last inspection and update

The last rating for this service was requires improvement (published February 2020) and there was one breach of regulation. 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 enough improvement had been made to meet that breach. However, a new breach of the regulations was identified, and the service remains rated requires improvement. This service has been rated requires improvement for the last two inspections.

Why we inspected

We undertook this focused inspection due to incoming information of concern including a safeguarding incident and to check they had followed their action plan to confirm they had met the legal requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for this service has remained the same requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 9 Glenville Drive on our website at www.cqc.org.uk.

We found evidence that the provider needs to make improvements. Please see the safe section of this full report. You can see what action we have asked the provider to take at the end of this 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 identified a breach in relation to unsafe recruitment practice, this may put people at risk of harm.

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 their recruitment practice. We will work with the 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.

9 Grenville Road is a residential care home providing personal care for two younger people living with a learning disability and/or autism at the time of the inspection. The service is registered to support two people.

People using the service lived in a semi-detached house, with shared kitchen and bathroom facilities.

Services for people with learning disabilities and/or autism

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 provider’s systems to monitor the quality and safety of the service had not always been effective at identifying where the registered provider needed to make some improvements. For example, ensuring annual environmental safety checks were completed.

People were supported by staff who knew their needs well. Staff supported people with their medicines but there was some improvement required to the medicine management administration processes. We have made a recommendation the provider ensures medicines are recorded appropriately, regularly reviewed and monitored when transferring between locations in line with current national guidance.

People were safe living at the home. Staff knew how to protect people from harm and reduce the risk of accidents and incidents. At the time of our site visit, we found there were enough numbers of suitably recruited staff on duty to meet people’s needs to keep people safe. Staff understood how to prevent and control the spread of infection.

People who had recently moved into the home had been assessed before being accepted to the service to ensure the provider could meet their needs. Assessments addressed the person’s physical and health needs and what was important to them. Staff had received training which helped them to deliver personalised care. Our observations showed people looked happy.

People were offered a choice of foods and where appropriate, received additional support with their dietary needs. Staff worked with external health and social care professionals and ensured people were supported to access these services when they needed them to maintain their health and wellbeing.

People were supported to have maximum choice, 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.

Staff spoken with were knowledgeable about people’s care and support needs. Staff enjoyed their work and had developed a good rapport with the people they supported. Staff encouraged people’s independence and protected their privacy.

Whilst on site, people looked comfortable with the way they were being supported and we saw positive interactions between people and staff. Staff provided care to people in line with their individual preferences and choices.

Complaints made had been investigated however, there was no system in place to monitor for trends. The culture of the staff team was to provide person-centred care and empowered people to maintain their independence as much as possible.

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

Rating at last inspection

This was the first inspection for this service since their registration (21 January 2019).

Why we inspected

This was a planned inspection.

Enforcement

We have identified breaches in relation to the governance processes at this inspection. Please see the action we have told the provider to take at the end of this report.

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.