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. About the service
Forget Me Not Caring is a domiciliary care agency registered to provide the regulated activity of personal care in supported living settings. The service currently supports 56 people with a learning disability and autistic people across 19 shared houses. People have their own tenancies and staff provide various levels of support depending upon people’s needs.
People’s experience of using this service and what we found
Right Support
Staff did not always support people to have the maximum possible choice, control and independence over their own lives. People were not always supported to make decisions following best practice in decision-making.
The provider did not always work proactively with people to plan for when they experienced periods of distress. Personalised support plans were not always in place and staff demonstrated a lack of understanding about how to support people appropriately at these times.
People were not always supported to plan and achieve their aspirations and goals. People’s care plans lacked information about what was important to them and what they wanted to achieve in the future.
Staff supported people with their medicines in a way that promoted their independence; however, the provider’s medicines processes did not always ensure people achieved the best possible health outcomes.
Staff supported people to play an active role in maintaining their own health and wellbeing, providing information and guidance about healthy eating and local sports facilities. Staff supported people to take part in a range of leisure activities in their local area.
Right Care
People’s care and support plans did not always reflect their needs and preferences or promote their wellbeing and enjoyment of life. Information was not person-centred and records were not always completed in a dignified or respectful way.
People were not always involved in planning or reviewing their own care or in making decisions about the management of risk.
Staff did not always have the necessary skills to understand people who had individual ways of communicating such as body language, sounds, Makaton [a form of sign language], and symbols.
The provider did not always ensure the systems in place protected people from the risk of poor care and abuse.
Right Culture
The ethos, values, attitudes and behaviours of the management and staff did not always ensure people led inclusive and empowered lives.
The culture of the service was not always positive and staff did not always understand best practice in relation to the wide range of strengths and needs people with a learning disability and autistic people may have.
The provider had not effectively evaluated the quality and safety of support provided to people. The monitoring systems in place were not robust and had failed to highlight concerns found during the inspection.
People and those important to them were not always actively involved in making decisions about care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 15 February 2021).
Why we inspected
We received concerns in relation to the oversight of the service, staff training and understanding of people’s needs and the quality of people’s care documentation. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led.
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 from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safeguarding, dignity and respect and oversight of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
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.