Accedo Herts South

At this location, there was a negative culture, where staff did not treat people with dignity and respect. Staff used inappropriate language to refer to people and when completing incident reports. People were not supported in a consistent and positive manner, in line with their care plans and risk assessments.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. Care was not consistently person-centred and did not always promote people's dignity, privacy and human rights. This was being addressed by the provider at the time of inspection, however, changes were yet to be embedded.

Risk assessments were not consistently developed to provide staff with the information they needed to ensure people's care was provided safely. This meant people were not supported in a consistent way to achieve positive outcomes. Feedback received from staff, relatives and professionals was mixed. Staff reported a high volume of training, however some felt it had not given them adequate skills to support people in a safe, consistent way. Relatives and professionals also felt that the quality of support provided was inconsistent.

People were not sufficiently safeguarded against the risk of abuse. Incidents were not managed appropriately or in a timely manner. This meant people were exposed to risk of harm. The management team reviewed accidents and incidents but this was not always effective in identifying patterns and trends. Incidents were not always investigated appropriately, and measures put in place to prevent reoccurrence. This was particularly evident at one of the supported living sites.

The provider found it challenging to recruit appropriate staff. Staff recruited lacked the necessary skills and values. As a result, there had recently been a period of high staff turnover, as the provider sought to address this issue. The registered manager explained that they had reflected on this situation and identified lessons learnt.

Whilst governance systems were in place, these were not utilised effectively to identify issues where practice could be improved. Both the registered manager and provider were open about the challenges they had experienced. Prior to the inspection they had developed a service improvement plan, however this did not include all of the issues we identified. A new service manager had been recruited and staff, relatives and professionals told us about improvements made since they joined.