3L Care Limited

The service can provide personal and nursing care, and treatment of disease, disorder and injury for up to 10 people. At the time of this assessment 8 people were receiving support with personal and nursing care, and treatment of disease, disorder and injury.

We carried out a responsive assessment of this specialist service following concerns raised related to how medicines were being managed and the use of restraint.

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgments 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.

At the time of the assessment, the service did not have a registered manager in post. A registered manager is the person legally responsible for running the service and making sure it meets all required standards. The current home manager was in the process of applying to become the registered manager.

The provider had been through a difficult period because of changes in management and ongoing staffing issues. During that time, there were safeguarding concerns, issues with medicines, and problems with how the environment was managed.

We found evidence that things had improved significantly. The service was becoming more stable, and positive changes had been put in place. These included stronger leadership, updated systems, and better outcomes for people using the service.

The provider had introduced effective safety measures. These included keeping an up-to-date record of risks, reviewing incidents quickly, using an electronic system to manage medicines, ensuring staff were properly trained, giving them regular supervision, and having proper oversight of safeguarding.

The leadership team was open about the previous problems and was taking sustained, meaningful action to put things right. Governance was moving away from short-term, reactive responses and towards more consistent, reliable and accountable ways of working.

Although many improvements had been made, we found problems with the safety of the environment and with infection control. These standards were not always kept up, which meant the environment was not always as safe or clean as it should be. The provider responded well to our feedback and took quick action to fix the issues we raised. We did not find evidence of widespread harm, but the provider needs to keep improving in these areas to make sure standards are met consistently.

Staff responded to people in a timely way. People were treated with kindness, and their dignity was respected. We observed calm, respectful and safe interactions in communal areas.  Each person had a care plan that reflected how they preferred to spend their time, along with their individual wishes and preferences. Care plans showed good clinical understanding and a personalised approach to meeting each person’s needs. However, some parts of the risk assessment process still needed more consistency to make sure the information recorded is reliable.

Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. They monitored people’s health to support healthy living. People had enough to eat and drink to stay healthy. However, some of the monitoring and review notes did not go into enough detail in the higher risk areas.

Staff helped people understand their care and treatment so they could give informed consent. They supported people to be involved in decisions and used communication aids when needed. When people could not make their own decisions, the provider involved those who were important to them to help make decisions in their best interests. However, written records for decision specific capacity assessments and explanations of why the least restrictive option was chosen were not always clear.

Health and social care professionals who work with the provider said communication had improved.

Most staff we spoke with told us morale had improved and leadership is clearer and more supportive.