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.About the service
Oakhurst Lodge is a care home, without nursing, that provides care and support for up to 8 adults with autism and learning disabilities and other multiple needs. The home is on the outskirts of the New Forest in a community setting between Southampton and Lyndhurst.
At the time of the inspection there were 7 people using the service.
People’s experience of using this service and what we found
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.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support
More needed to be done to ensure people were consistently supported to have a fulfilling and meaningful everyday life that included achieving aspirations and goals and having regular access to meaningful activities. Whilst the service had planned for when people experienced periods of distress, the plans lacked completeness and in some cases contained inaccuracies. This increased the risk of inconsistent approaches being used which could increase people’s distress. Staff were not consistently supporting people to make decisions following best practice. Staff enabled people to access health care services in their local community and care was provided in a clean and generally well maintained environment.
Right Care
Managers had not always ensured risks faced by people had been assessed and planned for. The risks posed to people due to the complex needs of their peers had not been adequately assessed and planned for. Concerns were raised that leaders had not always responded appropriately to concerns about abuse. More needed to be done to ensure staff understood people’s individual ways of communicating. There were usually sufficient staff deployed to meet people’s needs within the home, but hours aimed at supporting community activities were not being fully utilised.
Right culture
There were a range of governance processes in place, but these were not being fully effective, as the inspection found a number of areas where the safety and quality of care being provided had fallen below the required standards. The culture within the service was kind and caring and staff in all roles were passionate about their work. Staff were recruited safely.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This last rating for this service was good 27 February 2018.
Why we inspected
We undertook this inspection to assess whether the service was applying the principles of Right support right care right culture.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance the service can respond to COVID-19 and other infection outbreaks effectively.
The inspection was prompted in part due to concerns about record keeping, the management of incidents and potential restrictive practices being used. A decision was made for us to inspect and examine those risks.
We have found evidence the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement
We have identified breaches in relation to safe care and treatment, consent, person centred care, safeguarding people from abuse and good governance.
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.