CQC finds lack of stimulation in learning disability care home inspections

The Care Quality Commission found major concerns at three of the 10 care homes it inspected for people with learning disabilities.

The 10 reports are the latest in a targeted programme of 150 unannounced inspections of care homes and hospitals 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.

Inspectors found major concerns at three of the ten locations, Chaseways, run by Cambian Learning Disabilities Limited, Melling Acres run by Parkcare Homes Limited and The New Barn run by Claremont Clare Limited.

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.

At Chaseways, inspectors found 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.

The report also said: ‘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, treatment and rehabilitation that was required.’

The inspection found that although procedures were in place to prevent and identify abuse, they were not always followed.

Following the inspection, the Care Quality Commission (CQC) has received an action plan from Cambrian Learning Disabilities Limited and 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.

At Melling Acres, CQC inspectors found that although people’s care and support needs were assessed, most care plans were not up to date and some important information including that relating to their physical health needs was not in place.

The report said ‘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.' Since the inspection, the CQC has received an action plan setting out how Parkcare Homes is addressing the concerns.

At the New Barn, the CQC found 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 CQC 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.

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.

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.

The learning disability inspection programme was launched in response to the abuse revealed by undercover filming by the BBC Panorama programme. CQC apologised for failing to respond to warnings of abuse at Winterbourne View. Matters concerning Winterbourne view are the subject of serious case review.