The Care Quality Commission (CQC) has rated 61 Langley Road in Slough, Berkshire, inadequate and placed it in special measures following an inspection in November.
The inspection was prompted in part due to concerns received from local authorities regarding risks to people’s welfare and safety.
61 Langley Road is a domiciliary care agency providing care in seven supported living services across Slough, to people with mental health conditions, those living with learning disabilities and autistic people. At the time of the inspection there were 27 people being supported by the service.
Following the inspection, CQC issued five warning notices. This is to make sure the provider concentrates their attention on providing safe care and treatment, working through their safeguarding processes more effectively. The provider also needs to improve the management of the service, ensuring staffing levels are safe, as well as making sure they’re meeting the nutritional needs of people they provide care for.
The care agency’s overall rating has dropped from good to inadequate. It has also dropped from good to inadequate for being safe and well-led.
The service is now in special measures which means it will be kept under review by CQC and re-inspected to check sufficient improvements have been made.
Debbie Ivanova, CQC’s director for people with a learning disability and autistic people, said:
“When we inspected 61 Langley Road, we were incredibly disappointed that the standard of care had dropped significantly since our last inspection in January 2018. People’s basic safety and wellbeing needs weren’t always being met, and risks weren’t being effectively managed to keep people safe.
“The service wasn’t working collaboratively with people or their loved ones consistently. Staff couldn’t make decisions and had to get the registered manager’s permission before they could carry out daily tasks. This took away the sense of empowerment and use of initiative sometimes needed when working in a care environment.
“This meant that staff were unable to work pro-actively with people they provided care and support to and, decisions could not always be made to support peoples’ preferences and meet their needs effectively. For example, staff had sent a text message to the registered manager stating that someone wanted a staff member to accompany them to the accident and emergency department. The registered manager’s text response was, ' She must be joking lol' which was inappropriate and suggested this wasn’t going to happen. We found no records to confirm staff had accompanied the person.
“This type of oppressive, controlling practice is not acceptable and demonstrated the registered manager was failing to protect peoples’ human rights.
“We are working jointly with the local authorities who have also sought assurance from the provider. The provider has supplied plans regarding how they intend to implement the improvements needed. When we return, if we are not assured people are receiving the care they deserve, we will not hesitate to take further action to ensure they do.”
Inspectors found:
- There were restrictive work practices which weren’t proportionate to people who weren’t legally subject to control or restraint. For example, inspectors saw text messages dating back to October 2021 that showed staff contacting the registered manager to ask if a person could attend activities to which the registered manager’s response was only with his permission if their behaviour had been appropriate and he had refused the person permission to attend a therapeutic session
- A person, who was not subject to any lawful restrictions or restraints, wanted to know if they could order a takeaway, the registered manager gave permission for them to do so but stated this could only happen once a week
- A person's care records documented they had reported to staff they were threatened by male strangers whilst out accessing the community. Although staff had reported this incident to the police, there were no records to confirm they had also reported this incident to the local authority's safeguarding team and there were no records to show what further action was taken to make sure the person was kept safe from harm
- Medicines weren’t disposed of safely. A bag containing prescribed medicines belonging to people who were no longer living at the service, including controlled drugs was found stored in a spare room that was unlocked. This meant prescribed medicines were easily accessible to anyone in the building which could have led to possible drug misuse or accidental poisoning
- Records weren’t always accessible to people as legally required. This inspection was delayed as the general manager didn’t give us access to records relating to safeguarding and accidents and incidents. The lead inspector had requested to review these records on 17 November. . On the third day of the inspection, 24 November , the general manager continued to prevent access stating the files weren’t in order. Inspectors were eventually given limited access to the requested records. There wasn’t assurance that there were effective systems to ensure records relating to safeguarding accidents and incidents were completed or that staff had taken appropriate action
- A relative of another person had to ask staff for permission to take the person out for a walk. Text messages showed staff having to obtain the registered manager’s permission first.