Tuscany House

Tuscany House is a care home providing accommodation and personal care for up to seven people with learning disabilities and/or autism spectrum condition. There were six people living at the home at the time of our inspection.

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.

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

The service was not always able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

People’s medicines were not always managed safely. Some medicines had been administered after they had expired and there was insufficient guidance for staff about the use of medicines prescribed ‘when required’.

Some people did not have opportunities to take part in meaningful activities or to access their community. This meant people were not supported to have the maximum possible choice and control over their own lives.

Staff had not had the guidance they needed to provide support in a way which achieved good outcomes for people. Care plans did not always reflect people’s current needs or include guidance for staff about how to support them effectively.

Risk assessments were in place to help keep people safe. Accidents and incidents were reviewed and action taken to help prevent similar events happening again. The home was clean and hygienic, and staff understood how to minimise the risk of infection.

People were supported to maintain good health. Staff ensured people had access to appropriate professional input to meet their healthcare needs.

People’s dietary needs were met. People were supported to make choices about what they ate and to maintain a balanced diet.

Right care:

Staff did not have all the skills they needed to meet people’s communication needs. We have made a recommendation about this.

There were enough staff available to keep people safe. When agency staff were needed, the provider used the same staff regularly, which minimised the impact of this on people’s care. The provider’s recruitment procedures helped ensure only suitable staff were employed.

Staff knew how to recognise and report abuse or poor practice. When safeguarding concerns had been raised in the past, these had been reported and investigated.

Staff were kind and caring. They treated people with respect and engaged with them in a friendly yet professional manner. Staff had worked with people to help them overcome anxieties, which had achieved positive outcomes for them. People were encouraged to be independent where possible.

Right culture:

Inconsistent leadership had affected the quality of care people received and the support provided to staff.

The culture within the service did not always achieve good outcomes for people. People were not involved in developing their support plans to ensure they reflected their needs and wishes.

Quality monitoring systems had not been effective and did not include seeking the views of people who lived at the home, their relatives and staff.

Staff kept relatives up to date about their family members’ health and well-being. Relatives told us that any concerns they raised had been resolved to their satisfaction.

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

Rating at last inspection

The last rating for the service under the previous provider was outstanding, published on 16 August 2019.

Why we inspected

The service was registered under the current provider on 1 December 2020. This was a planned inspection based on the date of the service’s registration under the current provider.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.