The Care Quality Commission (CQC) today publishes a further 10 reports from a targeted programme of 150 unannounced inspections of hospitals and care homes that care for people with learning disabilities.
The programme is looking at whether people experience safe and appropriate care, treatment and support and whether they are protected from abuse. A national report into the findings of the programme will be published later this year.
Inspections were focused on two outcomes relating to the government’s essential standards of quality and safety: the care and welfare of people who use services, and safeguarding people who use services from abuse.
Inspectors found major concerns at three of the ten locations:
- Chaseways, run by Cambian Learning Disabilities Limited
- Melling Acres run by Parkcare Homes (No 2) Limited
- The New Barn run by Claremont Clare Limited.
People receiving treatment and support were not routinely involved in their care plans and health care did not show routine medical treatment accessible for people who use the service.
Staffing shortages sometimes restricted the number of activities available to people receiving treatment, and there was a lack of stimulation within everyday living for the people receiving treatment and support at Chaseways. The service did not provide the assessment and treatment and rehabilitation that was required
Although procedures were in place to prevent and identify abuse, they were not always followed.
- We have received an action plan from the provider. Following a visit in March, a Mental Health Act Commissioner reported that they were impressed with the comprehensive care planning and risk assessment documentation which had been regularly updated and noted that wherever possible, patients had contributed to their plans.
People’s care and support needs were assessed but most care plans were not up to date and some important information including that relating to their physical health needs was not in place.
There were some activities and experiences in place but these were limited. Whilst most staff were respectful to the people using the service there were examples when this had not been consistent.
The lack of advocacy limited the ways people had to express any concern.
- We have received an action plan setting out how the provider is addressing our concerns.
The New Barn
People received a service from a provider who had taken steps to prevent abuse. Staff had the knowledge of how to protect people from abuse, or the risk of abuse but did not fully record any restraints used. The home had not involved the local safeguarding authority appropriately making the independent oversight of people’s care more difficult to carry out.
- A safeguarding referral was made as a result of the inspection. These were made by the provider to the local authority and are being followed through. Staff are receiving further training about following the safeguarding policy.
All the services where concerns are identified have to tell the CQC how and when they will improve. Those failing to meet essential standards could face enforcement action by the regulator if improvements are not made.
Overall, one location is compliant with Outcome 4 (care and welfare of people who use services), two have minor concerns, five have moderate concerns and two have major concerns. On Outcome 7 (safeguarding people from abuse), four locations are compliant, one has a minor concern, three have moderate concerns and two have major concerns.
The batch contains one NHS, seven independent health care and two adult social care locations.
CQC inspectors were joined by ‘experts by experience’ – people who have first hand experience of care or as a family carer and who can provide the patient or carer perspective as well as professional experts in our learning disability inspections.
Where inspectors identified concerns, they raised these immediately with the providers and managers of services.
The national report will be based on the findings from all the 150 inspections and will make conclusions about the overall state of this type of service.