1 March 2023
During an inspection looking at part of the service
Taunton Deane Support Services provides care and support to people with learning disabilities and autistic people who live in their own homes. The service supports people who live in Somerset, Bath and North East Somerset and Bristol. It is registered to provide personal care. At the time of the inspection the service was providing personal care to 21 people living in 9 separate settings. Some people lived in their own home; other people house shared. Where staff slept in to ensure people were safe overnight, they had a private space to do so in a spare bedroom.
In 'supported living' settings people's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.
CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
People’s experience of using this service and what we found
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.
The provider was not able to demonstrate how they were meeting all of the underpinning principles of Right support, Right care, Right culture.
Right Support
The quality of care and support people received across different settings was not consistent. In 2 settings, people had not always received the care they needed to live safe and happy lives. Staff did not always support people with their medicines in a safe and effective way and risks to people had not been fully considered and planned for.
Recruitment processes were safe, and the provider was taking active steps to recruit and retain staff. Some settings relied on high levels of temporary staff who did not always have the skills, experience or knowledge to meet people's needs and expectations.
Right Care
People were not always treated respectfully or with compassion. Staff did not always understand or respond to people's individual needs.
Staff had training on how to recognise and report abuse but had not always applied it. Staff had not protected people from poor care and abuse in 1 setting. The service was currently working with other agencies to do so.
People's care and support plans did not always accurately reflect their range of needs or risk and this had not promoted their wellbeing.
Right culture
The culture varied across the service. In 2 settings, people had not received high quality care and support. In 2 other settings we visited people felt engaged, listened to and were happy with their support.
People's quality of life was not enhanced by a culture of learning and improvement. Neither the provider nor the registered manager had effective oversight of practice in all people’s care settings. This had led to people receiving poor or unsafe care.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 25 January 2019).
Why we inspected
We received concerns in relation to safeguarding, the safety of people’s care and the management and oversight of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 to requires improvement following this inspection.
Enforcement
We have identified breaches in relation to protecting people from abuse, providing safe care, care planning and governance and oversight of the service. We have also made 1 recommendation in respect of medicine administration practice.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.
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.