Royal Mencap Society - 22 Lamberts (Daisy)

About the service

22 Lamberts (Daisy) is a residential care home providing personal care and support and is registered to support to up to five people. The service provides support to people with a learning disability, autistic people, as well as support for people's mental and, or physical healthcare needs. At the time of our inspection there were five people living at the service.

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

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 support: People were supported by staff who were familiar with their needs. Staff took into account any risks when providing people’s care and worked collaboratively with other health and social care agencies. Families were important contributors to people’s care.

Right care: The service had turned around its rating of inadequate to good. The service was able to demonstrate how they were measuring the quality of what they did. It was ensuring people had good outcomes of care and able to access the right resources and support. People were going out in line with their needs and choosing what they wanted to do. Staff had the right training and support for their roles and understood what constituted good care.

Right culture: Management were open and visible and had created a culture of learning, opportunity and reflection. Staff were encouraged to speak out and contribute to the development of the service. People were empowered to live their lives in line with their preferences and were given the opportunity to have new and repeated experiences. The environment was conducive to people’s needs and a rise in living standards enhanced people’s wellbeing.

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

This service was inspected on 28 March 2022, report published 8 June 2022 This was its first inspection since a change of registration on 10 December 2020. The service was rated inadequate overall with four breaches of regulation. This service has been in Special Measures since 23 May 2022. 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.

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 and the provider was no longer in breach of regulations .

Why we inspected

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.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for on our 22 Lamberts (Daisy) website at www.cqc.org.uk.

22 Lamberts (Daisy) is a residential care home providing personal care and support to up to five people. The service provides support to people with a learning disability, autistic people, as well as support for people’s mental and, or physical healthcare needs. At the time of our inspection there were five people living at the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability 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 service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support: The standards of care provided, did not support people to have choice and control over their own care and lifestyles. This was compounded by the level of staff available to meet people’s assessed needs, and corresponding limitations on access to the community. The overall condition of the premises needed to be addressed, to ensure people lived in a clean and comfortable environment.

Right care: Care records did not demonstrate people were involved in the development of these documents, or that their individual wishes and preferences were consistently reflected. People’s dignity, privacy and human rights were not being upheld, particularly in relation to the implementation of the Mental Capacity Act (2005). People were not always supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Gaps in staff training and competency checks did not ensure staff had the necessary skills, knowledge and expertise to safely meet people’s needs.

Right culture: There was a lack of leadership within the service, due to there being no registered manager. The provider team representatives visited the service to carry out audits and checks. Inspection findings highlighted the provider’s audit findings were not being addressed. This did not ensure improvements to the quality of people’s care or the condition of the care environment were made. People were not being empowered to lead meaningful lives, or to be part of their local community.

Rating at last inspection and update

This service was registered at this location on 10 December 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the safe running of the service, in relation to medicines management, staffing levels and training to meet people’s assessed needs and risks. A decision was made for us to inspect and examine those risks.

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.

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

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 22 Lamberts (Daisy) on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, including the management of infection such as COVID-19, staffing, good governance and oversight of the service at this inspection.

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 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.

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.