Adam House

We have 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 2 continued breaches of the legal regulations in relation to safe care and treatment and good governance. However, enough improvements had been made since our last inspection in relation to safeguarding and fit and proper person employed, therefore the provider was no longer in breach of regulations in these areas.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. In relation to some of our concerns, we have asked the provider for an action plan in response to these issues found at this assessment.

We found concerns with some elements of people’s risk management records, the environment and medicines, therefore further work was needed to ensure people were kept safe. There was enough staff in place with the right skills, qualifications and experience, but rotas were not always accurate. Managers made sure staff received training but records relating to this needed to be updated. Regular appraisals and supervisions were taking place to promote high-quality care. The registered manager told us they were looking to drive improvement in the areas where we identified concerns.

Peoples assessments were not always as detailed as they needed to be. People always had enough to eat and drink. Staff worked with all agencies involved in people’s care for the best outcomes and to support smooth transitions. People’s health was monitored and people understood information about their care and treatment to enable them to give informed consent.

People were treated with kindness and compassion. Staff protected people’s privacy and dignity. Staff treated people as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.

People were involved in decisions about their care, but records around their care needed to be improved. The service provided information people could understand. People knew how to give feedback. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. Work was required to ensure peoples end of life wishes had been considered and recorded.

Leaders were visible, and supportive, helping staff develop in their roles, but leaders had not always been able to drive the improvements needed. Governance and oversight needed to be improved. There was not always a culture of continuous improvement as some concerns from our last inspection remained unresolved. Leaders and staff had a shared vision and culture. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas.