Michdeede LTD

The provider had the service user band to support people with a learning disability and autistic people. The Care Quality Commission(CQC)use‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability 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 was not supporting any autistic people or people with a learning disability, but the providerdid not haveregard to ‘Right support, right care, right culture’.

However, systems were not sufficiently robust to keep people safe. Risk assessments and care plans did not always give staff clear guidance, were inaccurate for one person and were not available in one person’s home. Medicines were not managed safely: staff administered medicines without evidence of current training or competencyassessments,Medicine Administration Records (MAR) and medicines risk assessments were not available in people’s homes.MAR charts which were provided later to the CQC lacked detail.

Safe recruitment processes were not followed, with missing application forms, references, interview notes and insufficient Disclosure and Barring Service(DBS)records and other recruitment checks.DBS checks provide information including details about convictions andcautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff had not received an effective induction, mandatory training,supervisionor appraisal in line with the provider’s policies and procedures. Two staff told us they wanted more training.

Some care plans reflected people’s goals and health needs. However,reviews and evidence of people or relatives being involved were limited, and consent to provide care was not recorded.

Quality assurance and governance arrangements were ineffective, with no clear audits of the service, no recorded spot checks and poor oversight of records and care.

Overall, while people and relatives experienced caring relationships and continuity from staff, leadership and governance were not sufficiently developed to assure safe,consistentand well-led care.

The provider was in breach of the legal regulations relating to safe care and treatment, good governance,staffingand fit and proper persons employed.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

This service is being placed inspecial measures. The purpose ofspecial measuresis to ensure that services providing inadequate care make significant improvements.Special measuresprovide a framework within which we use our enforcement powers in response to inadequate care and provide a time frame within which providers must improve the quality of the care they provide.