Baobab Care UK Limited

The assessment was prompted following a review of information we held about the service and information which had been shared by commissioners.

The service is a Supported Living Service and provides personal care to people living in their own homes. Not everyone was receiving personal care. CQC only inspects where people are receiving the regulated activity personal care. This is help with tasks related to personal hygiene and eating. Where they do, we consider any wider social care provided. At the time of this assessment 16 out of 30 people were receiving support with personal care. The service supports people with learning disabilities and autistic people; younger adults; mental health conditions; sensory impairment and physical disabilities.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and access to communities that most people take for granted. ‘Right support, right care, right culture’ is guidance CQC follows to make assessments and judgements about services supporting people which providers must adhere to. We found the provider was not consistently meeting the principles of Right support, right care, right culture.

People’s needs, preferences, aspirations and outcomes were not routinely reviewed in accordance with its principles. This limited people’s opportunity to live an ordinary life and be supported in ways that reflected their individual choices and goals. When the provider made changes and adjustments to the living accommodation of people this guidance had not been fully considered.

During the assessment we spoke with 7 people and 5 relatives/representatives.

Risks to people were not always assessed, monitored or managed effectively. Environmental safety checks and fire safety arrangements were not robust. Recruitment processes were not always followed, and no audits were in place for these. Governance systems were not effective enough to identify and address shortfalls, and the provider had limited oversight of risk and quality. This included the safe management of medicines and finances and the cleanliness of the environment. Care plans and risk assessments lacked information to guide and inform staff about safe and effective care. People’s care records did not consistently detail goals, aspirations or opportunities for people to build their independence or develop new skills.

Overall, staff worked well with external health and social care professionals to support people’s needs.

Risks were not always managed well, and staff lacked clear guidance about people’s known health conditions. The information and instructions given to staff required improvement so they could manage risks properly and support people safely.

A lack of provider’s audits of the service, meant they had failed to identify the concerns we found during this assessment.

Not all staff had received suitable training, competency assessments and regular supervisions to maintain high-quality care. We could not be assured there were enough staff with the right skills, qualifications and experience to support people safely.

Recruitment practices were not robust, including the appropriate checks prior to staff commencing employment and working with vulnerable people.

We reviewed documents as part of the assessment including but not limited to; care records, staff files, incidents and accidents, safeguarding, compliments and complaints.

At this assessment we found breaches of 6 regulations relating to person centred care, safe care and treatment, safeguarding, good governance, staffing and fit and proper persons employed.

In instances where CQC has 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.

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