Archived: 17 Edward Road

17 Edward Road is a supported living service providing personal care and support for up to 11 people. The service provides support to people with severe and enduring mental health needs including dual diagnosis and people with a learning disability and/or autism. 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. At the time of our inspection there were nine 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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right support

People spoke positively about staff and the support they provided. People’s independence was promoted and supported. Staff supported people to achieve their goals and to take part in activities that met their interests. People’s needs and risks were assessed, documented and reviewed to ensure they were safely met. There was a complaints procedure in place in formats that people could understand.

Right care

Staff protected and respected people’s privacy and dignity. People had support to access health and social care professionals when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Right culture

People received good care and support. People were involved in planning for their care and support. The provider took people's views into account and feedback was used to help drive improvements. There were effective systems in place to assess and monitor the quality of service that people received. The service worked with health and social care professionals to ensure people's needs were safely met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 10 May 2021)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 17 Edward Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

17 Edward Road provides personal care and support to people with severe and enduring mental health needs including dual diagnosis. The service focuses on providing support to people living within a supported living environment and works to help people gain the necessary skills to lead independent lives. People shared communal areas and had their own bedroom personalised to their preferences and needs. At the time of our inspection 11 people were using the service.

People’s experience of using this service

People spoke positively about staff and told us they felt safe and were happy living at the service. There were safeguarding policies and procedures in place and staff had a clear understanding of these procedures and the actions to take if they had any concerns. Risks to people were assessed, documented, reviewed and monitored to ensure their needs were safely met. Medicines were safely managed, administered and monitored. Recruitment checks took place before staff started work and there were enough staff to meet people’s needs safely. The service had procedures in place to reduce the risk of the spread of infections and Covid 19 and staff had enough personal protective equipment to help keep them and people using the service safe.

There were effective systems in place to assess and monitor the quality of service that people received. The provider took people’s views into account on a regular basis and feedback was used to help drive improvements. Staff told us they received support from the registered manager and provider. The service worked well with health and social care professionals to ensure people’s needs were safely met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 14 December 2020) there were several breaches of regulation. The provider completed an action plan after the inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

The ratings from the comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the safe key question. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 17 Edward Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

17 Edward Road provides personal care and support to people with severe and enduring mental health needs including dual diagnosis. The service focuses on providing support to people living within a supported living environment and works to help people gain the necessary skills to lead independent lives. People shared communal areas and had their own bedroom personalised to their preferences and needs. At the time of our inspection 11 people were using the service.

People’s experience of using this service and what we found

People were not always safeguarded against the risk of abuse and harm. Safeguarding concerns were not always acted on and reported immediately as required in line with best practice. The service failed to report and respond appropriately where possible harm, abuse or an incident had occurred. Systems and processes were not operated promptly or effectively to investigate allegations of harm and abuse, to prevent abuse from occurring.

Risks to people's physical and mental health support needs were not always safely assessed, monitored and reviewed to ensure their safety and well-being. Risks associated with people's physical health needs were not always safely managed and monitored by staff to avoid possible harm.

Medicines were not always safely managed. PRN (when required medicines) protocols were not always in place. This meant staff did not monitor and know when to administer these medicines. Records and risk assessments did not clearly guide staff to know when medicines needed to be administered or what doses were required. Some records did not always clearly guide staff on the symptoms to look out for or when to administer medicines safely and appropriately.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The service demonstrated they were underpinning the principles of Right support, right care, right culture.

Audits to help support management oversight in ensuring good service delivery were not effective in identifying the concerns we found during this inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good report published (23 March 2018).

Why we inspected

We received concerns in relation to a safeguarding incident. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from ‘Good’ to ‘Requires Improvement’. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

We have identified breaches in relation to managing risks to people safely; protecting people from the risk of abuse and; ensuring effective systems were in place to monitor the quality and safety of the service at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 17 Edward Road on our website at www.cqc.org.uk.

Edward Road is a 24 hour supported living project in Bromley, which provides specialist support for people with mental health needs. The accommodation consists of 11 bedrooms and shared communal areas and facilities. At the time of our inspection there were 11 people using the service. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff supervision and support was not always regularly available due to the past absence of the registered manager. However action was taken to address this and we will check on staff supervision and support at the next inspection of the service.

Risks to people were assessed, recorded and managed safely. Medicines were managed, administered and stored safely. People were protected from the risk of abuse, because staff were aware of the action to take if they had any concerns. There were systems in place to ensure people were protected from the risk of infection. Accidents and incidents were recorded and acted on appropriately. There were safe staff recruitment practices in place and appropriate numbers of staff to meet people's needs.

There were processes in place to ensure staff were inducted into the service appropriately. Staff received training to support them to fulfil their roles effectively. Staff were aware of the importance of seeking consent from people and demonstrated a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This provides protection for people who do not have capacity to make decisions for themselves.

People were supported to meet their nutritional needs and preferences and people had access to health and social care professionals when required. People told us staff treated them well and respected their privacy. People were involved in day to day decisions about their care and had care plans in place which reflected their individual needs and preferences.

People were supported to maintain relationships and they were supported to engage in a range of social activities. People’s needs were reviewed and monitored on a regular basis. People were provided with information on how to make a complaint. The service worked with health and social care professionals to ensure people's needs were appropriately met. There were systems in place to monitor the quality of the service provided. People's views about the service were sought and considered through meetings and satisfaction surveys.