About the service:

Bobbins is a residential home providing care to young adults with learning disabilities. The accommodation is a detached house in the town of Swindon. There is a parking area in front of the building secured by electric gates and an enclosed garden at the rear. The home is registered to provide care for up to six people. There were six people living in the home at the time of our visit.

People’s experience of using this service:

People were unsafe due to risks not being managed effectively. Where risks were identified clear guidance on how to manage these risks was not available to staff. Staff told us they sometimes did not feel safe.

Accidents and incidents were not always investigated or used as an opportunity for learning and to prevent future reoccurrence. Staff understood their responsibilities in relation to safeguarding, but safeguarding incidents were not always fully investigated and recorded.

Medicines were not always kept secure.

The environment was not always clean or safe for people using the service and all environmental risk assessments were out of date.

Consent forms were signed by people’s relatives who had no legal rights to do so.

Some people had no opportunity to engage in activities outside of the service.

The provider did not have effective systems in place to monitor the quality of the service they provided or to drive improvements where needed. Some records were not always available, accurate or complete.

People were treated with kindness and respect. People’s right to privacy and confidentiality was respected. People were all involved in making decisions about the premises and environment, regardless of their ability to communicate.

Rating at last inspection:

Good (Last report published 25 March 2017).

Why we inspected:

This inspection was brought forward in response to incidents that had occurred at the service and concerns that had been raised about the safety and management of the service.

Enforcement:

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

Following the inspection we referred our concerns to the local authority responsible for safeguarding. In addition, we requested an action plan and evidence of improvements made in the service. This was requested to help us decide what regulatory action we should take to ensure the safety of the service improves.

This inspection took place on 20 February 2017 and was unannounced.

Bobbins is a residential home providing care to children and young adults with learning disabilities. The accommodation is a detached house in the town of Swindon. There is a parking area in front of the building secured by electric gates and an enclosed garden at the rear. The home is registered to provide care for up to 6 people. There were five people living in the home at the time of our visit.

At the time of our inspection the service did not have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service was managed by a nominated individual. The nominated individual has overall responsibility for supervising the management of the regulated activity, and ensuring the quality of the services provided.

Statutory notifications had not always been sent to the CQC by the provider. A statutory notification is information regarding specific incidents that have occurred and is required by law to be shared with the commission. These include safeguarding alerts, serious incidents and deaths of people receiving a service. However, this had no impact on people’s health and well-being. All safeguarding notifications had been reported to the local safeguarding team. The nominated individual took immediate action and sent statutory notifications retrospectively.

Staff understood what protecting people from harm or abuse was, and had received training in safeguarding. Staff understood their roles and responsibilities in keeping people safe and took actions when they were concerned about people's safety.

Risks of harm to people were assessed and action was taken to minimise the risks through the effective use of risk management plans. Staff knew people's risks and followed their risk assessments and management plans.

There was a sufficient number of suitably trained staff to keep people safe and meet their needs in a timely manner. Staff had been recruited in line with safe recruitment procedures to ensure they were of good character and fit to work with people who used the service.

Staff helped people manage their medicines safely. Staff had been trained to administer medicines with regard to safety regulations and precautions. Staff’s competence was reviewed regularly to ensure the medicines were administered safely.

Appropriate checks and maintenance of people's living environment were carried out. Contingency plans were in place to ensure safe delivery of people's care in the event of adverse situations such as large-scale staff sickness or accommodation loss due to fire or floods.

Staff understood the importance of gaining people's consent to the care they were providing to enable people to be cared for in the way they wished. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).

People's needs in relation to nutrition and hydration were documented in their care plans. People received appropriate support to ensure that they received sufficient amounts of food and drink. Meals, drinks and snacks provided to people suited their dietary needs and preferences.

People received regular health care support and were referred to other health care agencies for support and advice if they became unwell or their needs changed.

People who used the service were supported by caring and attentive staff who understood their individual needs and knew their preferences for how care and support should be delivered. Staff explained things in a way that people could easily understand. They remembered to make eye contact and treated people with dignity and respect.

Staff provided people with personalised and respectful care based on the g