Affinity Trust - South West

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

We carried out this assessment in response to concerns we had received and the age of the rating. At our last inspection the service was rated good. At this assessment the service has been rated requires improvement.

We found people were not always protected from the risk of harm as staff did not always have all the information needed to meet people's needs safely. Risks to people were not always assessed and mitigated.

Care records reviewed were of mixed quality. Improvements were needed to ensure medicines were managed safely.

People were not always supported to have maximum choice and control of their lives. Where people lacked capacity to make decisions, the Mental Capacity Act 2005 (MCA) code of practice was not always consistently followed.

Where people had health professional guidance for staff to follow, staff were not always aware of or following this. Staff did not always receive appropriate training to meet people’s specific needs.

The providers governance and oversight systems had not identified all concerns we found. However, the provider gave assurances relating to the additional governance and oversight systems and processes they had implemented during our assessment, though these were yet to be embedded.

People were being supported by enough staff who had been recruited safely. Staff provided information in a format people could understand. Our observations of interactions between staff and people were positive. People were treated with kindness and compassion. Staff protected people’s privacy and dignity.

We received mixed feedback relating to how supported staff felt. Some staff told us they felt isolated, others commented they were well supported by managers. Staff felt confident to speak up and told us they were treated equally, free from bullying or harassment.

The registered manager and provider were open, honest and responsive throughout the assessment, acting on any queries raised.

The provider was in breach of the legal regulations relating to safe care and treatment, person centered care, staff training and governance. We have asked the provider for an action plan in response to the concerns found at this assessment.