Gateholme

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

We found concerns in relation to infection prevention and control, particularly in the kitchenettes and bathroom areas. The provider took appropriate actions to ensure these concerns were resolved and mitigated in the future.

People's medicines were predominantly managed safely, and medicines were administered as prescribed. However, we found areas which required improvement. The registered manager took immediate actions to address these concerns, however we have made a recommendation that medicine audits are reviewed and updated to ensure issues can be identified and resolved in a timely way.

Accidents and incidents were recorded and analysed to ensure risks were identified and mitigated. However, this process could be improved to include environmental factors.

There were enough staff available to support people in a timely way. The provider ensured staff were recruited safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care People told us they enjoyed living at the service and felt staff supported them well. Relatives told us they

were satisfied with the care and support offered to their relatives.

Right Culture A person centred culture was not always promoted within the service. For example, staff were not always quick to respond when people required support with personal hygiene. We also saw people's dignity was not always promoted.

Systems in place to monitor the service were not always effective. Audits had not been instrumental in identifying or resolving concerns we identified during the inspection process. Confidential and sensitive information was not always stored in line with the Data Protection Act. Care documentation was often left in communal areas. The registered manager took action to address these concerns, however new systems and processes require embedding into practice to ensure effectiveness.