Smitham Downs Road

Updated 14 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two Inspectors and a member of the CQC medicines team carried out the inspection.

Service and service type

Smitham Downs Road is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Smitham Downs Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. A new manager had been appointed by the provider and was due to start in their role in May 2022.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five members of staff including the deputy manager and regional manager. We observed interactions between people and staff to help us understand the experience of people who could not talk with us. We reviewed a range of records. This included two people’s care records and five people’s medicines records. We looked at staff files in relation to staff recruitment. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection we continued to seek clarification from the provider to validate evidence found. We looked at information about people’s care and support, supervision and training data for staff, complaints and records relating to the management of the service including quality assurance records. We spoke with four relatives and received feedback from them about their experiences of the service.

Updated 14 June 2022

About the service

Smitham Downs Road is a residential care home providing personal care to seven people at the time of the inspection. The service can support up to nine people with learning disabilities and/or autistic people.

The service was previously known as Care Management Group - Smitham Downs Road. The current provider took over the management and operation of the service from the previous care provider in December 2020.

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 the 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

Staff did not always support people with their medicines to achieve the best possible health outcome. Information about people’s ‘as required’ medicines (PRNs) was inaccurate, out of date or incomplete which increased the risk of people not taking these in a timely or appropriate way. Staff did not always follow systems and processes to make sure all medicines were managed and administered safely. However, people received their regular prescribed medicines at the right time. Some people were being unlawfully deprived of their liberty at the service as the provider had not obtained the proper legal authorisation to do this. This meant people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service at the time of this inspection did not support this practice.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. Staff enabled people to access specialist health and social care support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood how to protect people from poor care and abuse. They had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. The service had enough staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People’s care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right Culture

People’s quality of life was not always enhanced by the provider’s governance processes. These had not always been effective in taking action to keep people safe, protect people’s rights and provide good quality care and support.

People were supported by trained staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff turnover at the service had improved which supported people to receive consistent care from staff who knew them well. People and those important to them, were involved in planning their care. Staff evaluated the support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views.

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

Rating

This service was registered with us on 1 December 2020 and this is the first inspection. The last rating for the service under the previous provider was good, published on 17 April 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service. 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.

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

We have identified breaches in relation to need for consent, 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.