CQC report explained · a residential care home
What the CQC found at 246 Haymill Close
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, June 2023
Rated Requires Improvement; inspectors found kind care and enough staff, but safety, dignity, legal authorisations and management checks were not consistently reliable.
This was an unannounced focused inspection on 27 and 29 March 2023. Inspectors spoke with people, staff, relatives and professionals. They observed care and checked care plans, medicine records, health and safety records, training, recruitment and quality checks.
The home supported people with learning disabilities and/or autism. Inspectors found enough staff, kind care in many situations, good support with food and health appointments, and involvement of people and relatives in care planning.
However, some safety risks were not managed consistently. Medicine records and checks were incomplete. Three liberty authorisations had expired without timely review. Inspectors also saw people’s dignity was not always respected, and management systems did not identify or fix problems quickly enough.
The overall rating changed from Good to Requires Improvement. Safe, Effective, Caring and Well-led were all rated Requires Improvement. The report does not give a separate Responsive rating.
Enough staff
Inspectors saw enough staff on duty to keep people safe and meet their needs. Staffing had recently been increased to respond to a change in one person’s mobility.
“There were sufficient staff to help people be safe and meet their needs at the time of our visit.” from the report
Kind interactions
Staff often supported people in a friendly and respectful way. Inspectors saw staff respond kindly when someone became upset.
“We also observed staff supporting people in a fun, friendly and respectful manner.” from the report
Involvement in care
People and relatives were involved in planning and reviewing care. Staff took time to understand individual communication styles and support choices.
“Staff involved people and their relatives in planning and reviewing their care.” from the report
Safe infection controls
Inspectors were assured about the home’s infection prevention measures, including its use of protective equipment and arrangements for outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Unmanaged safety risks
seriousA sensor device recommended to help monitor a person at risk of falling had taken months to obtain. The report says this increased the risk of harm.
“delays in obtaining this device meant there was an increased risk the person may be harmed if they fell.” from the report
Medicine records
seriousThe home could not show regular stock checks for some when-required medicines. Records did not always state the dose given.
“these records did not always clearly record the dose of 'when required' medicines when staff had supported a person to take this.” from the report
Dignity was not consistent
seriousInspectors saw staff speak about a person without including them, and move or touch someone without explaining what they were doing. This was a continued breach.
“We observed instances when staff spoke to each other about a person over the person without including them in the conversations.” from the report
Expired liberty authorisations
needs fixingAuthorisations affecting three people’s liberty had expired more than two months before the inspection. The home had not applied to review them in time.
“the authorisations to deprive 3 people of their liberty had expired over 2 months before we inspected and the provider had not applied to review these.” from the report
Weak quality checks
seriousAudits and monitoring did not identify or deal with several problems quickly enough. Records were not always accurate or up to date.
“The quality assurance systems had not always ensured that the service addressed risks to people's safety and well-being, protected people's rights and that people were always treated with dignity and respect.” from the report
- 01What has been done to make sure all safety risks, including falls risks and sensory needs, are recorded and acted on promptly?
- 02How do you now check stocks and doses for when-required medicines, and can you show recent audit results?
- 03Have the three expired liberty authorisations been reviewed or renewed, and how will you prevent this happening again?
- 04What training or supervision has been given to staff about dignity, explaining physical contact and speaking directly to people?
- 05What action has been taken in response to the Regulation 17 warning notice, and what evidence can you share that records and quality checks have improved?
This was an unannounced focused inspection that began with Safe and Well-led, then widened to include Effective and Caring; the report gives no separate Responsive rating. This explanation was written from the published report of 21 June 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, July 2022
Support for Living Limited - 246 Haymill Close is rated Good; inspectors found improved safety and leadership, but there was no permanent registered manager in post.
This was an unannounced focused inspection on 14 June 2022. One inspector met people and staff, checked care and quality records, medicines and safety arrangements, and spoke with two outside professionals. Infection control was also checked.
Inspectors rated Safe and Well-led as Good. They found risks were assessed, medicines were managed safely, there were enough staff, and people were protected from abuse and avoidable harm. The home was clean and staff worked with other professionals.
The home had improved since the previous inspection, which was rated Requires Improvement and found a breach of Regulation 12. At this inspection, the provider was no longer in breach.
This was a focused inspection. The report only examined Safe and Well-led in detail. The overall Good rating also used ratings from the previous inspection for the other areas.
Risk management
People's risks were assessed, regularly reviewed and managed in ways that supported choice rather than unnecessary restriction.
“Risks to people's wellbeing had been assessed and planned for.” from the report
Enough staff
Inspectors found enough suitably trained staff to meet people's needs, provide one-to-one support and help people take part in activities.
“The service had enough staff, including for one-to-one support, for people to take part in activities and for their needs to be met.” from the report
Personalised support
Staff knew people well and adapted their communication and support to individual needs, choices and cultural requirements.
“Staff knew people well, communicated with them in a personalised way and understood their needs.” from the report
Safe medicines practice
Medicines were stored, administered and recorded safely. The home also worked with prescribers to review medicines and avoid excessive use.
“Medicines were safely stored, administered and recorded.” from the report
Permanent manager not yet appointed
needs fixingThe registered manager had left shortly before the inspection. An acting manager was in place while the provider recruited to the permanent post.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has a permanent registered manager now been appointed, and how will the transition be managed?
- 02How are risk assessments reviewed and updated for each person?
- 03What extra training and support have staff received about personalised medicines support?
- 04How does the home check that people continue to have choice, independence and opportunities to take part in activities?
- 05How are families and people living at the home involved in decisions and service improvements?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 1 July 2022 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 246 Haymill Close
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- July 2022Goodup from Requires improvementSafe: GoodWell-led: Good
- November 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
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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