Availl (Bury St Edmunds)

Whilst we found some improvement in the quality of care and risk management plans the service remained in breach of the regulation. Progress to make all necessary improvements to the governance and oversight arrangements was ongoing and due to some changes in management this had impacted on progress and timescales.

Systems in place to ensure staff received appropriate induction, support and training that is necessary for their role continued to be in need of improvement.

The service had been without a registered manager since February 2021. The provider's oversight and governance of the service continued to be ineffective.

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 CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: The provider had safeguarding processes in place. Staff understood how to ensure people were protected from the spread of infection. However, people told us they experienced constant changes of care staff.

Staff were recruited safely.

Right Care: People told us staff were kind and caring and were treated with respect, however some people told us they did not always have the opportunity to give feedback. Improvements had been made to the provider's systems to assess and manage risks safely for people and were ongoing to support people to have maximum choice and control of their lives and for staff to support them in the least restrictive way possible and in their best interests; the polices and systems in the service to support this practice were also

being reviewed.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives.

Systems for auditing had been introduced but needed further development to consistently evidence and document the actions taken and where applicable lessons learnt.

There were mixed views about the communication from the office, some people said it was good and others said it was not good at all. Staff told us the constant change in management had impacted on morale.

The provider had an electronic call monitoring system in place which for the most part was effective. People told us overall they felt safe with all staff who supported them. Risk management plans were in place, we have made a recommendation about improving risk assessments for people with a diagnoses of epilepsy.

We recommended the provider uses a reliable system to monitor staff care calls to ensure they continued to be delivered according to people's care plans.