29 March 2018
During a routine inspection
Broadpark House is a ‘care home’ for up to three people with a learning disability. The registered provider lives in the home and together with her husband they provide the care. At the time of our inspection there were two people living at Broadpark House. The two people living at the service were independent and only required occasional prompting and support. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection in November 2016 we found breaches of legal requirements. These were regulations:
• Regulation 17 – Good governance. Due to the unusual nature of the service there were no formal systems and processes in place to assess the quality and safety of the service and there was a lack of policies and procedures in place relevant to the planning and delivery of care and treatment.
• Regulation 18 – Staffing. Staff had not received any up to date training to enable them to carry out their roles in line with best practice guidance.
• Regulation 20 A – Requirement as to display of performance assessments. The provider had not displayed their CQC rating, which is a legal requirement of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
As a result the service was rated as ‘requires improvement.’ This inspection found that these three breaches remained. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question(s) effective and well-led to at least good. However, we did not receive any action plan.
When we visited we met with the registered provider. A registered provider is a person who has registered with the Care Quality Commission to run the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations. A registered manager is not required as the provider is registered as an individual person.
Staff had still not received up to date training specific to people’s needs; this was also identified at both our inspections in 2015 and 2016. The provider explained at both these inspections, they would contact the relevant professionals if they noticed changes in a person’s physical or mental health.
There were still no policies and procedures for us to view during our inspection, this was the same in 2015 and 2016. For example, a policy on safeguarding vulnerable adults, risk management and infection control. We also found that the home did not have a Mental Capacity Act (2005) policy in place to provide the legal framework to work within to ensure the protection of people in their care. However, the registered provider knew to contact relevant professionals if any concerns became evident which impacted on people.
The service was unusual in so far as it was more of a family home. There were still no formal systems and processes in place to ensure quality for people. The service is run in an informal way through on-going discussions with people on a constant basis.
The provider was not keeping up to date with training, changes in practice, regulatory requirements and had no quality monitoring systems. Therefore they were unable to assess whether or not they were meeting the required standards or provide evidence that risks were being managed.
Prior to our inspection we asked the provider to send us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. The provider did not respond to our request for information.
Since April 2015, providers have been required to clearly display their Care Quality Commission (CQC) rating at any premises from which they provide a regulated activity. We found that the provider of Broadpark House had still not displayed their CQC rating.
The provider has not made the required improvements. They have not responded to regulatory requests for an action plan or other information.
We have contacted the local authority requesting reviews take place for the two people living at Broadpark House. We will also be meeting with the registered provider to discuss the on-going breaches and what actions they plan to take to meet the Health and Social Care Act regulations.
People felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. However, there was no safeguarding policy in place for them to refer to. Measures to manage risk were as least restrictive as possible to protect people’s freedom. Staff demonstrated an understanding of the Mental Capacity Act (2005).
Care files were personalised to reflect people’s preferences. People were supported to maintain a balanced diet, which they enjoyed. Health professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.
Staff relationships with people were caring and supportive. People’s privacy and dignity were respected.
There were regular opportunities for people and people that matter to them to raise issues, concerns and compliments through informal discussions.
We found three repeated breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.