Distinct Care and Support

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The service was supporting one person with personal care at the time of the inspection.

People were supported by a staff team who worked unsafe rota patterns. The risks to people and staff relating to this had not been assessed.

People had care plans that showed information about their likes, dislikes and needs. However, there was a lot of duplication in the documentation which could be confusing to staff. In other aspects of their care, actions and outcomes were not recorded, for example reviews of care, health professional input and goals.

The registered manager had not reported incidents or sought appropriate professional support for people to reduce the risks of future incidents. There was a lack of effective systems to assure the quality of the care delivered. This meant the registered manager was unable to identify concerns for themselves and relied on external agencies to inform them of areas that required improvement.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

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

This service was not able to demonstrate how they were meeting some of the underpinning principles of

Right support, right care, right culture. There was some evidence of finding out what people's choices were and supporting people to achieve them, for example enabling past hobbies, supporting religious and cultural beliefs and access to community activities (COVID-19 government restrictions allowing).

However, positive behaviour support and the Mental Capacity Act principles were not yet fully understood by the registered manager and some staff and therefore not promoted to protect people's rights and choices. Opportunities to develop work and independence skills were missed and people were not fully empowered. Changes to people's support were only as a result of external input and suggestions as systems and practices did not support staff to be proactive and identify areas for improving people's opportunities.

Despite the concerns found during the inspection, people told us they were happy at the service, felt safe and were supported by a staff team they liked and could talk to.

People were supported to access a variety of health professionals when needed.

People's medicines were well managed, and people told us these were always correct and on time.