Sobell Lodge - Care Home Physical Disabilities

We undertook this inspection in response to concerns raised about the quality of care provided, the management of risk, and the overall leadership and oversight of the service

The service provides care and support to people with physical disabilities, autistic people and people with a learning disability. ‘Right support, right care, right culture’ (RSRCRC) 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. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

We found that staffing levels were insufficient to ensure the delivery of safe, effective and person‑centred care. Staff did not consistently receive the support, supervision or guidance necessary to carry out their roles effectively. Incidents, accidents and safeguarding concerns were not always reported in line with required procedures and lessons were not always shared to ensure learning and reduce the risks of incident reoccurring. Risks to people were not always fully assessed, and the measures in place were not robust enough to promote or maintain people’s safety. In addition, the home environment was not consistently clean, as the communal living area was found to be poorly maintained. Health and safety checks were carried out. However, actions were not always completed.

People’s needs were assessed when they started using the service. However, these were not always updated, and care records did not always contain information about people’s background and histories to help staff understand the individual. Staff were not always caring, respectful and understanding in their approach.

The management of the service was not effective. Staff complained about the lack of stable management and leadership of the service which had impacted on their effectiveness. We found records were not up to date, for example, records of people’s care and records relating to the management of the service were not always maintained. Complaints and concerns about the service were also not up to date. Incidents and accidents were not always analysed and followed up. Care records were not up to date and easily accessible to support staff. However, the provider had identified some of the issues we identified and had developed an improvement plan which they shared with us.

Staff upheld the principles of the Mental Capacity Act and supported people in the least restrictive way. They promoted people’s rights, freedoms and choices, and people were able to decide how they wished to spend their time within the home. Individuals were involved in the day‑to‑day running of the service, and staff encouraged them to express their views about how the service operated. People knew how to raise any concerns they had.

Staff supported people to meet their nutritional needs and enabled them to take part in social activities and community events. The environment was well adapted and accessible, promoting independence.

We identified 3 breaches of the legal regulation in relation to safe care and treatment, safe and effective staffing and good governance.

We have asked the provider for an action plan in response to the concerns found at this assessment