What the CQC found at 68 West Park Road

Inspectors found there were enough staff to support people, although the home regularly used agency staff.

“People were supported by adequate numbers of staff, although the service depended on regular agency staff use.” from the report

Overall, people were supported safely with their medicines. Staff also followed principles intended to avoid unnecessary over-medication.

“Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).” from the report

Care records included people's preferences and guidance about how they wanted support with cultural and religious needs.

“People's care records were phrased as if written by them rather than about them.” from the report

Records showed people were supported by different health professionals when needed.

“Records showed people were supported by a range of health professionals as needed.” from the report

Fire doors needed replacing, some door-closing mechanisms were not working and the alarm panel could not identify the correct flat. Combustible materials and a hole in the boiler room wall also created fire risks.

“All the fire doors in the home were no longer fit for purpose and needed replacement.” from the report

Unexplained bruising was not reported or investigated promptly. Incident records were sometimes incomplete, and management checks did not always identify this.

“This meant there had been no attempts to identify the cause or consider any possible ongoing risks to the person.” from the report

Care records were not always up to date and staff were confused about who might need restrictive practice. Agency staff did not receive the same training as permanent staff.

“This meant there was a risk of staff using restrictive practice inappropriately or being unable to recognise what inappropriate restrictive practice was.” from the report

Quality systems did not reliably identify safety problems, poor incident records or staff who had gone a long time without supervision.

“Systems had not always enabled the management team to assess, monitor and mitigate risks to the health, safety and welfare of people using the service.” from the report

Some staff had not received regular supervision, and training records were difficult for managers to monitor. Agency staff also had little or no formal supervision.

“In one case we saw a staff member had not had supervision since 2019.” from the report

Some shared lounge areas were dusty, and damaged walls in parts of the home could not be cleaned easily.

“We noted during our visit areas of the shared lounge were dusty and in need of cleaning.” from the report