1 Charmandean Road in Worthing has been rated inadequate overall, following a Care Quality Commission (CQC) inspection in January.
1 Charmandean Road is a residential care home providing personal care to eight people with learning disabilities or a variety of associated health and support needs.
In December 2020, Achieve Together Limited took over the running of the service. CQC carried out an unannounced comprehensive inspection of the service to check the new provider was applying the principles of right support, right care, right culture, and that the service was safe, effective, caring, responsive and well-led.
Following the inspection, the service is rated inadequate overall, and inadequate for being safe, effective, caring and well-led. It is rated requires improvement for being responsive. Under the previous provider, the service was rated good overall.
Hazel Roberts, CQC’s head of adult social care inspection, said:
“We expect health and social care providers to guarantee people with a learning disability and autistic people the safety, choices, dignity, and independence that most people take for granted. When we inspected 1 Charmandean Road, we saw that staff were treating people with kindness and compassion. However, staff said they didn’t feel respected, supported or valued by senior staff. As a result, some staff had left the service and the provider had been unable to replace them. This meant there weren’t enough staff meet people’s needs and they didn’t always have the right skills to support people.
“We found that that people weren’t being kept safe, particularly when they were distressed. During our inspection we saw one person hitting their head several times because they were unhappy. Staff told us they did this on a daily basis, yet the person hadn’t been referred for additional support. Staff also told us they were sometimes pinched, scratched or bitten by people when they tried to support them. Yet they were not expected to complete incident reports in these situations. These reports are used to ensure that a service learns from each incident and makes changes to prevent the same thing from happening again to protect people and staff. Our inspectors reported these incidents to the local authority safeguarding team to protect people from risk of harm.
“We also found that people’s privacy and dignity were not always respected. During our inspection, we saw one person moving around the home with no clothes on. They did this on a regular basis, walking into communal areas and other people’s bedrooms. Staff, and other people living in the home regularly saw this, and one visitor told us it made them feel uncomfortable. Staff should have taken action to protect this person’s dignity, arranging specialist support if needed.
“In addition, people did not have as much freedom or control over their lives as they should have done. For example, one person had been put in a wheelchair with a lap belt on to stop them grabbing at things and other people, when they should have been encouraged to walk around the house and only use their wheelchair outside. We also heard people didn’t have many opportunities to go out, as there were not enough staff who could drive.
“Following the inspection, we told the provider to make a number of improvements to ensure people receive safe, effective and responsive care. They responded by telling us that they had plans to make improvements, including introducing additional staffing and management support. We will continue to monitor the service to ensure that the improvements are made and fully embedded.”
CQC found the following during this inspection:
- The service did not have enough staff to meet people’s needs. Staff did not feel respected, supported or valued by senior staff and did not always feel they were listened to, so some staff had left the service and the provider had been unable to replace them
- People were not kept safe from avoidable harm because staff and managers failed to report and manage incidents safely
- The provider did not always manage the safety of the living environment and equipment
- People did not have as much freedom, choice and control over their lives as possible because staff failed to manage risks to minimise restrictions
- Records did not provide relevant information for staff. For example, risk assessments had not offered guidance to support a person when they experienced distress
- Support plans did not always reflect people's range of needs, and staff were not always trained to support people using the service. For example, sensory needs had not been assessed for a person with a sight impairment and staff were not able to use Makaton (a form of communication which uses symbols, signs and speech) to communicate with people
- People were not always safe from abuse. Systems and processes to protect people from the risk of abuse were not operating effectively. When incidents of allegations of abuse were known, they had not been reported to the local authority safeguarding team or CQC
- The service was unable to evidence they had treated all concerns and complaints seriously, investigated them and learned lessons. Some staff said they were unable to raise concerns with managers for fear if what might happen. A lack of confidence and trust in confidentiality of the service had prevented staff and relatives from voicing concerns.
However:
- People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to. Staff spoke respectfully of people and demonstrated genuine regard. They knew peoples likes and dislikes and supported them in a caring manner. People were relaxed with staff and spoke positively about the service and the staff
- People received their medicines safely in accordance with the prescriber's instructions
- The home was clean and hygienic, and the service used effective infection, prevention and control measures to keep people safe, and staff supported people to follow them
- People were supported to eat and drink enough to maintain a balanced diet, in accordance with their individual needs.
Full details of the inspection are given in the report published on our website.
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