CQC report explained · a residential care home
What the CQC found at Rapid Review & Resettlement
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Rated Requires Improvement; inspectors found kind interactions and activities, but serious safeguarding, restrictive-practice and governance failures led to warning notices.
Inspectors visited on 26 July and 1 August 2023, as part of inspection activity from 25 July to 4 August. They spoke with staff, a person living at the home, relatives and health professionals. They reviewed care records, staff recruitment files, training records and management systems.
The home was not always safe or well managed. Inspectors found unclear records about physical interventions, missed safeguarding notifications after some self-injurious incidents, unsafe recruitment checks and weak checks on incidents, food, staffing and out-of-hours practice.
People were generally seen having kind interactions with staff and taking part in activities. However, the home did not always support choice, independence, healthy eating or person-centred goals. Locked doors and other restrictions had not always been properly considered or reviewed.
All five CQC areas were rated Requires Improvement. This means the home was not consistently meeting the expected standard and there was limited assurance about safety and quality. The previous overall rating was Good, published on 24 December 2019.
Kind staff interactions
Inspectors saw staff supporting people kindly, and people appeared relaxed around them. Relatives also said their relatives were safe and staff responded to their needs.
“We observed kind and caring interactions from staff when supporting people. People were relaxed in staff's presence.” from the report
Activities and family contact
People were supported to take part in activities at and away from the home. This included walks, cycling, parks, the zoo, cinema visits and seeing family.
“People were supported to join in activities away from the home which included walks, cycling, visiting the zoo and visiting local parks.” from the report
Communication support
Care plans included communication needs. Staff used pictures, social stories and electronic tablets to help people communicate.
“Staff were using pictorial images and social stories to support communication with people who used the service.” from the report
Access to health professionals
People were supported to use several health services, including GP, psychological, psychiatric, dental and podiatry support.
“People were supported to access healthcare services such as GP, psychological and psychiatric support, podiatry and dental services.” from the report
Safeguarding reports were missed
seriousSome incidents of self-injury that caused injury were not reported to the local authority or CQC, and medical help was not always sought. This creates a serious safety concern.
“Incidents of self-injurious behaviour where injury had occurred were not always reported to the local authority nor was medical intervention always sought.” from the report
Restrictions were not properly reviewed
seriousInternal doors and one person's lounge were locked without all the restrictions being considered through the required decision-making process. Physical intervention plans also lacked clear agreed instructions.
“The provider was not following the principles of the MCA for their approach to the use of restraint and restrictive practices.” from the report
Weak management checks
seriousAudits did not identify problems with incident records, nutrition, recruitment or staff arrangements in vehicles. The provider also did not carry out recorded out-of-hours spot checks.
“The provider did not operate effective systems and processes to make sure they assessed and monitored the service.” from the report
Care plans lacked detail
needs fixingPlans did not always explain how staff should support people during physical aggression or help them achieve their goals. Assessments focused too much on managing behaviour rather than the whole person.
“Support plans did not always clearly describe the action staff needed to take to effectively support people.” from the report
Nutrition was not consistently supported
needs fixingDiet records did not show enough fruit and vegetables for one person, and staff said dietary restrictions were not always followed. The provider had not fully assessed people's nutritional and hydration needs.
“People were not always supported to eat a healthy and nutritious diet.” from the report
Recruitment checks were incomplete
needs fixingOne staff member started before references were obtained, and three files had only character references. Required risk assessments had not been completed in these cases.
“The providers processes to ensure staff were safely recruited were not always followed.” from the report
- 01What has changed since the inspection to make sure every self-injury incident is reported correctly and medical help is obtained when needed?
- 02Which doors or rooms are currently locked, and how has each restriction been assessed as necessary and least restrictive?
- 03How are physical interventions now described, authorised, recorded and reviewed?
- 04How are care plans being updated to cover healthy eating, independence goals and the exact support each person needs?
- 05How are recruitment checks and out-of-hours management checks now completed and recorded?
This inspection looked at all five CQC key questions, the premises and care provided, and infection prevention and control; visits took place on 26 July and 1 August 2023. This explanation was written from the published report of 22 November 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2019
Rated Good; inspectors found safe, caring and well-managed support, with some fire, legionella and medicines checks needing improvement.
This was the first planned inspection since the home registered. One inspector visited on 03, 05 and 06 December 2019. They spoke with two residents, two relatives and five staff, observed care, and checked care records, medicines, training, audits and building checks.
The home supports up to seven people with a learning disability and/or autistic spectrum disorder. It provides a 12-week rapid review and resettlement service. Inspectors found detailed risk plans, enough trained staff, safe medicines systems overall, kind care and good support for choice, independence, health needs and communication.
The overall rating was Good, with Good ratings in all five areas. Inspectors found that fire and legionella risk assessments were not robust, two boxed medicines did not match the records, and the home could improve by checking people's progress after they moved on. The provider said it would take action on these points.
Detailed risk planning
Risk assessments covered everyday activities, community activities and known risks. Staff understood how to reduce risks while supporting people to build independence.
“Risk assessments were present and detailed how to reduce people's known risks.” from the report
Kind and respectful care
Inspectors saw staff respond patiently and compassionately. People's privacy, dignity and wishes were respected.
“Our observations showed people were supported by staff who were attentive to their needs, patient and compassionate.” from the report
Skilled staff
Staff received training in areas including autism, epilepsy, medicines and managing actual or potential aggression. New staff also completed an induction.
“Training provided staff with the skills and knowledge they needed to meet people's needs.” from the report
Support for independence
The care model aimed to help people gain skills, make choices and become more independent. Inspectors saw examples of people becoming involved in activities such as preparing meals.
“A strong ethos of the service was promoting people's independence.” from the report
Good partnership working
The home worked with health and social care professionals, and acted on their advice. It also created resettlement plans for people's next placements.
“Staff worked with other health and social care professionals to make sure people's needs were met.” from the report
Fire and legionella assessments
needs fixingInspectors said both assessments were not robust and needed more scrutiny. A new fire assessment identified additional works at medium risk, and the provider said these would soon be completed.
“However, we found both the fire and legionella risk assessments were not robust and required further scrutiny of the assessments.” from the report
Medicines records
needs fixingTwo people's boxed medicines did not match the recorded balances. Inspectors judged this to be a recording issue and the deputy manager said medicines audits and handover checks would be strengthened.
“During the inspection we identified two people's boxed medication did not tally correctly.” from the report
Checking longer-term outcomes
minorThe home did not yet have a clear review of people's progress after the 12-week service ended. Inspectors said this would help show whether the care model worked in new placements.
“The service would greatly benefit with a review of people's progress post the 12-week rapid review and resettlement service.” from the report
- 01What work was identified in the new fire risk assessment, and has all of it now been completed?
- 02What changes were made to medicines checks and handovers after the two boxed medicines did not match the records?
- 03How do you review a person's progress after they leave the 12-week rapid review and resettlement service?
- 04How will you make sure the next placement can safely meet the person's needs?
- 05How are the person's communication preferences, choices and activities recorded and reviewed during the 12 weeks?
This was the first planned inspection and covered all five CQC questions: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 24 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Rapid Review & Resettlement
2 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2019GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018
Registered with the Care Quality Commission on 5 December 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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