3 June 2019
During a routine inspection
The Briars is a residential care home for up to five people living with a learning disability. The service was providing personal care to four young adults at the time of the inspection.
People’s experience of using this service and what we found
Health and safety standards had not been maintained and records to manage risk were not effective. Lessons had not been learned and analysis of incidents had not taken place. Recruitment procedures were not robust. People received their medicines, however medicine records needed to be improved. Staff followed safeguarding procedures. There were sufficient staff on duty.
People were not always supported to have maximum choice and control of their lives and staff did not robustly 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.
Improvements to the environment were needed. Staff received supervision but not an appraisal. Some training was not up to date. We have made a recommendation about these. The service supported people with their healthcare and dietary needs. Guidance from professionals had been followed.
People were supported with their independence. However, where risks were identified, their independence could be limited. We made a recommendation about this. Privacy and dignity were maintained. Staff understood people’s needs, however staff had not recognised how the wider risks identified during inspection increased the risk of potential harm to people.
Care records were not accurate or up to date. Reviews did not determine if the care provided was relevant. People were not supported with information in appropriate formats. People were supported with activities. No complaints had been received, however systems were in place to manage these.
The provider lacked oversight of the service. Quality assurance systems were ineffective. Feedback was sought, but not used to drive improvement. Staff were supported by the registered manager. The service worked well with professionals and had good links with their community.
The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had not always or consistently applied them.
The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons – People could not access the garden area independently. Where risks were identified, people’s independence could be limited. Care records did not assist staff to support people to lead fulfilled lives.
The size of service meets current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life.
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 overall rating was Good (Published 15 February 2018).
Why we inspected
The inspection was prompted in part due to concerns received about practices of staff when supporting people using the service. A decision was made for us to inspect and examine those risks.
We found no evidence to show that people were at risk of harm by the practices of staff. However, 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.
Following feedback during inspection, the provider had started to take action to mitigate the risks identified.
You can see what action we have asked the provider to take at the end of this full report.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.