14 July 2022
During a routine inspection
About the service
Sanctuary Supported Living (Bromley Care Services) provides personal care to up to 15 people with a learning disability and/or autism in two supported living settings. Most people using the service also have a physical disability.
People using the service lived in one of two houses with shared communal facilities. 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 our visit, the service supported ten people on one site and five people at the other site.
People’s experience of using this service and what we found
Right Support:
Arrangements to support people to make decisions did not follow best practice in decision-making in relation to their support. The model of care and setting did not always support people's choice, control and independence. Although one site had wheelchair accessible cooking facilities, these were not utilised to foster people’s independence and skills.
The service did not support people consistently to have the maximum choice, control or to be as independent as they could be. Arrangements to support people to make decisions did not follow best practice in decision-making in relation to their support.
There were sufficient numbers of suitably skilled staff to meet people’s assessed needs. Staff knew people well and understood their communication needs.
Right Care:
The service at both sites was run more as a care home with group-based activity and planning, rather than a model of care that was fully person centred.
Some decisions in relation to activities, routines and food choices were made with staff as a group rather than supporting people with person centred planning and choices in these areas, to increase choice and meet their preferences in these areas.
People’s human rights were not always promoted as their diverse needs were not assessed and there was an absence of records to show how these were effectively supported.
People’s care was not planned in line with best practice guidance; people were not supported to identify goals.
Staff knew how to keep people safe but risk assessments records did not always include risk management plans.
We have made a recommendation around the assessment and management of risks.
People and their families told us they thought people were safe and well looked after. Staff understood how to recognise and report any signs of abuse or neglect.
Medicines were safely administered and managed.
Staff enabled people to access health and social care support from health professionals. The service worked with people to plan for when they experienced periods of distress or anxiety. People were provided with information about the service in an accessible format.
Right Culture:
Staff were kind and considerate to people and interacted with warmth. However, the ethos of the service and staff behaviours did not always proactively consider aspects of people’s support needs with a view to increasing their autonomy and empowering them to lead fuller lives in the community.
There was a system for monitoring the quality and safety of the service but this was not always effective and had not identified many of the issues we found.
The provider did not ensure staff training needs were fully monitored or that staff fully understood the training and were able to put it into practice.
The provider had an Equality Diversity and Inclusion Strategy and shared information about some campaigns and developments with staff. However, we found there was an absence of proactive provider leadership in terms of ensuring staff were supported to fully embed best practice in relation to people with learning disabilities.
Following the inspection the provider sent us information to show how they had recently developed resources for staff they were introducing to promote community involvement and person-centred planning.
Overall people and their families were positive about the management and staff at the service. People’s views about the service were sought through tenants’ meetings and key worker sessions.
Staff were positive about the support they received from the management team and the provider. They told us they worked well together as a team.
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 the service was at a different address and the name of the service has changed since the last inspection. It was previously known as Sanctuary Home Care Ltd – Bromley. The last rating for this service was good, (Report published 9 July 2019.)
Why we inspected
This inspection was prompted by a review of the information we held about this service and to check if the service was applying the principles of 'Right support right care right culture.'
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can see what action we have asked the provider to take at the end of this full report.
The registered manager has taken action to start to address the issues we found.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sanctuary Home Care Ltd – Bromley on our website at www.cqc.org.uk.
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.