The Firefly Club Care Home

The Firefly Club is a residential care home providing accommodation and personal care to up to 8 people with a learning disability and/or autistic people. The service also provides a domiciliary care service to people in their own homes. At the time of our inspection there were 6 people living in the residential care home and 4 people using the domiciliary care service.

People’s experience of using this 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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Improvements had been made following our last inspection. Staff understood people’s risks and the support they needed to remain safe. Records did not always provide staff with comprehensive guidance in relation to all the risk associated with people’s care. Some records relating to the management of the service were also not sufficiently comprehensive. The provider’s internal monitoring processes did not always identify these shortfalls and the provider was working at strengthening the effectiveness of their audits. We have made a recommendation in relation to people’s finance records.

Right Support: People’s care planning documentation was personalised and reflected their strengths and needs. The registered manager promoted a positive risk-taking, person-centred culture which had been embraced by the staff team. There was a positive culture of reviewing and reducing restrictions placed on people to keep them safe to support people to have maximum choice and control of their lives. The registered manager had made appropriate DoLS applications and had effective systems in place to renew and meet any conditions of authorised applications. People were supported to have maximum choice and 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.

Right Care: People told us they were happy. People appeared comfortable with staff and knew them. People were offered choices and various activities. People were spoken to respectfully, patiently and provided time to process and respond to information. People’s care planning documentation promoted independence, dignity and privacy.

Right Culture: Since the last inspection the provider had made changes which had improved the environment. People were being supported to choose items for their home and ideas and suggestions were continuously being sought from people, relatives and staff. The registered manager and staff team were supporting people to identify new activities and experiences.

People and staff told us there were enough staff. Our observations during the inspection confirmed this. Since the last inspection training had been prioritised by the provider. The registered manager had effective systems in place to monitor staff training. Staff told us they felt supported by the registered manager and the provider and were able to make suggestions and provide feedback to improve the service. The registered manager and provider were passionate about supporting best outcomes for people and improving people’s quality of life and had plans to continue to improve the service for 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 inadequate (published 30 January 2023) and there were 7 breaches 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 some improvements had been made and the provider was no longer in breach of 6 of the regulations. However, we found the provider remained in breach of regulation regarding governance.

This service has been in Special Measures since 30 January 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

Enforcement and Recommendations

We have identified a breach in relation to good governance at this inspection. We have made a recommendation in relation to financial records.

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

The Firefly Club is a residential care home providing personal care and accommodation to 6 people at the time of the inspection. The service can support up to 8 people.

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

Right Support: People were not supported to have maximum choice and control of their lives. 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. The provider was not able to demonstrate how they were meeting the underpinning principles of right support, right care right culture. The service was not maximising people's choices, control or independence.

Right Care: People were not always supported to make meaningful choices. There was a lack of person-centred care and people's human rights were not always upheld. People were not supported to lead inclusive and empowered lives. People had care plans in place. However, these were not always written in a way that was person centred and easy to understand; we found inconsistencies in care plans, a lack of detail and care plans which had not been updated to reflect the current support people were receiving. People were at increased risk of not being supported in the least restrictive way possible and in their best interests.

Right Culture: The service was not well led. The quality assurance systems to assess and monitor the service were not always in place, and where they were, they were not effective. We found the provider did not have enough oversight of the service to ensure it was being managed safely and quality maintained. Quality assurance processes had not identified all of the concerns in the service. Records were not always complete. Indicators of a closed culture were identified, and staff morale was low. Staff did not feel confident in raising concerns with the provider. This meant people did not always receive high quality care. We have made a recommendation related to safeguarding.

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 the service was good (published on 30 May 2019).

Why we inspected

The inspection was prompted in part due to concerns received about governance and concerns shared by the local authority relating to care planning, risk management, staffing and medicines. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to staffing, person-centred care, safe care and treatment, premises and equipment, assessing and monitoring risk and good governance at this inspection.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The Firefly Club has been registered since November 2018 and is available to provide care and support for up to 8 people.

People’s experience of using this service:

People and relatives told us the home was a good place to live, and that staff treated them with respect and kindness.

People’s health and social care needs were identified and managed well by the management and staff team. There were positive relationships with professionals, which supported people’s overall wellbeing.

The environment was safe, clean and suitable for people’s needs.

People were supported to take their medicines by well trained and knowledgeable staff, who understood their preferences of how they wished to take them.

People received enough to eat and drink and were involved in choices about what they wished to eat.

People were supported by sufficient staff, and the registered manager ensured that staff were trained in all areas that were deemed necessary in order to support people’s needs effectively.

The management team showed evidence of ongoing quality monitoring across all aspects of the home. Any concerns or suggestions for improvement which were raised by residents, their families or staff were addressed.

The home showed a good level of leadership, by encouraging people who use the service to be involved in their care.

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 participated in meaningful activities, in which they were supported to be as independent as possible.

People received responsive care and support which was personalised to their individual needs and wishes.

Documentation in care plans was clear, person centred and regularly reviewed with the person and their family or advocate if appropriate.

Rating at last inspection:

The service had not previously been inspected

Why we inspected:

This was the first scheduled inspection following the homes 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