Cera - Wiltshire

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right Support, Right Care, Right Culture’ is the guidance The Care Quality Commission follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. Providers must also ensure they have an understanding of “stopping over medicating of people with a learning disability and autistic people” (STOMP).

The assessment was a fully comprehensive inspection, which looked at all key areas. During the last inspection we found the provider was in breach of the legal regulations in relation to medicines administration, good governance and ensuring fit and proper staff employed. During this inspection we found improvements in all these areas had been made and the service was no longer in breach of regulation.

We identified some shortfalls with the provider’s governance systems. However, the provider had an awareness of these shortfalls and had developed an improvement plan.

Care being delivered on time was still a concern, and the service was only meeting a 74% rate of on time visits. This was picked up in monthly audits but sufficient progress had not been made by the provider to meet their own key performance indicators (KPIs).

Staff had been recruited safely with all pre-employment checks completed prior to them starting. Staff training was current, in line with national standards and all staff had the care certificate qualification as a minimum. However, we identified some shortfalls in risk management where people’s risks had not been documented. Staff told us leaders and managers supported them well. The provider had a focus on staff well-being, organising team meetings and informal drop-in sessions at the registered office. All staff had completed safeguarding training and expressed confidence that any concerns raised would be addressed appropriately by leaders. However, there were some shortfalls with care planning documents which lacked documentation relating to people’s capacity. Most care plans contained personal preferences regarding how people liked their care to be delivered.

Staff protected people’s privacy and dignity. They treated people as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends.

People were not always involved in decisions about their safety, and care plans did not always contain detailed, dynamic information tailored to individual needs. This shortfall meant people were not always empowered to maintain independence and control over their lives.

Environmental safety was embedded into everyday practice. Staff were trained to identify hazards and escalate concerns promptly, supported by regular competency checks and scenario-based learning. Proactive referrals ensured people’s homes were adapted to meet changing needs. This enabled people to feel safe and respected in their own environment.