59 Bury Road

59 Bury Road is a residential care home providing accommodation and personal care to up to 6 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 6 people using the 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.

Based on our review of the key questions safe, effective and well led, the service was not able to demonstrate they were fully meeting the underpinning principles of Right support, right care, right culture.

Right Support: People had their own individualised care plans in place, but they were not always reviewed or updated to ensure they reflected people’s most current needs. There were ineffective systems in place to monitor incidents, which meant there were missed opportunities to avoid and reduce reoccurrence. There were policies and systems in place to support people’s choice, control and independence, but these were not always followed, People were not always supported to have the maximum possible choice, control and independence in their daily lives. Care was not always documented to accurately reflect how staff had supported people in a positive way.

Right Care: Staffing levels impacted on people receiving person-centred care. People were not always provided with opportunities to utilise their commissioned 1 to 1 support, tailored to them to enhance and enrich their lives. However, staff had a good understanding of people’s needs and the provider recognised where people responded positively to specific staff members when supporting them when anxious or upset. People were comfortable and happy in staff’s presence and staff we spoke to were knowledgeable about people’s needs.

Right Culture: There was inconsistent leadership at the service which resulted in ineffective governance and quality assurance systems. There were audits and action plans in place to improve the quality of care. However, these were not consistently completed and in some cases actions were not followed up or documented. This meant that improvements were not always implemented, the provider’s governance systems were not always followed and issues around the quality of care and safety of the environment at the service were not always addressed. Relatives and health and social care professionals told us there had been communication difficulties with the provider, which at times had not promoted a positive working relationship around planning and reviewing people’s care.

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

Rating at last inspection

This service was registered with us on 1 December 2020. We carried out an Infection prevention and control inspection of the service in January 2021, where the service did not receive an inspection rating.

Why we inspected

We received concerns in relation to staffing and safeguarding people from the risk of suffering abuse. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. The overall rating for the service is requires improvement.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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.

We found the following examples of good practice.

¿ Arrangements were in place to reduce the spread of infection. People using the service had tested positive to Covid-19 and were self-isolating in their own rooms or communal areas when appropriate. People's individual needs were considered to ensure everyone was kept safe.

¿ Infection prevention and control (IPC) procedures were clear and followed by staff. All staff were trained in safe IPC practices, during our visit, we observed staff wearing appropriate PPE and plentiful supplies were available around the home.

¿ There was a clear regular programme for staff and people living in the home to be tested for COVID-19. This meant swift action could be taken if or when positive tests were received.

¿ People were supported to maintain contact with their relatives in different ways including window visits, using technology and by telephone. A warm and safe area was available for relatives to visit their family members, for when visiting restrictions were eased. There were procedures in place for essential visitors, which included temperature and health checks.

¿ The provider's infection prevention and control policies and procedures were up to date and a monthly

audit had been carried out. A Covid-19 Response Plan and business contingency plan were in place and had been followed. The management team were working closely with the local authority and clinical commissioning group.