TerraBlu Homecare

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.

The management team were not aware of Right support, right care and right culture. Based on our review of safe and well-led, the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support Staff supported people to complete personal care tasks and activities to meet their assessed needs set out in the care plan. However, care plans for people with a learning disability and or autism were not structured to support people to achieve their goals and aspirations.

Right Care The provider did not have effective safeguarding systems in place to protect people from the risk of abuse. Safeguarding concerns related to older people had not always been reported to the local authority. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right culture People and those important to them, including advocates, were involved in planning their care.

Individual risks were not always assessed and managed to keep people safe. Care plans were in place. However, care plans and risk assessments were inconsistent and did not always detail the relevant information staff would need to meet people's assessed care and health needs. People could not be sure their prescribed medicines were always managed in a safe way. When people had accidents and incidents, appropriate reports had not been completed.

People could not be assured new staff were adequately checked and had received training to ensure they were suitable to work with people to keep them safe. We found no evidence that people had been harmed however, systems were either not robust enough to demonstrate staff recruitment was effectively managed.

The systems in place to audit the quality of the service were not robust or sufficient to alert the provider of the concerns and issues within the service. Audits had not picked up areas which were identified during the inspection. Registered persons had failed to notify CQC of incidents and events such as abuse and serious injuries.