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CQC report explained · a residential care home, run by Achieve Together

Gallaudet Home

Poolemead Centre, Watery Lane, Bath, BA2 1RN

Requires improvementpublished 31 August 2023, 3 years ago

Rated Requires improvement: inspectors found the service was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
People were protected from abuse and there were enough staff, with medicines and infection control generally managed safely. However, staff lacked training and knowledge to support people who became distressed, creating a risk of incorrect support.
Effective?
Requires improvement
People received support from staff who knew them and could access health professionals. However, capacity and best-interest decisions were not always recorded lawfully, and specialist training was incomplete.
Caring?
Good
Staff were described as kind, approachable and respectful. People’s privacy, dignity, differences and beliefs were supported, although not everyone was helped to build independence as much as possible.
Responsive?
Requires improvement
People had some personalised care information and could express preferences, but care plans and communication profiles lacked important detail. Access to activities and the community varied, and some requests were not acted on.
Well-led?
Requires improvement
The new manager and provider showed a willingness to improve, and staff felt supported. However, audits had outstanding actions, care records were inconsistent, specialist training was incomplete and knowledge of some legal duties needed improvement.
The latest report, explained

What inspectors found, August 2023

Gallaudet Home is rated Requires Improvement; inspectors found kind, respectful care, but concerns about decision-making, specialist training, care records and people’s opportunities.

This was an unannounced inspection over two days. Inspectors communicated with five people using British Sign Language, observed care, spoke with relatives and staff, and checked medicines, care plans, training, recruitment and management records.

The home supported seven Deaf people with learning disabilities, autism and mental health needs. Staff were caring and usually knew people well. People were supported to contact family, access healthcare and use parts of the home and local community.

However, staff did not always have the specialist skills to support people who became distressed. Care plans and communication information were not always detailed or up to date. People were not always supported to make decisions lawfully, develop independence, follow their interests or achieve their full potential.

The overall rating and all questions except Caring were Requires Improvement. Caring was rated Good. This was the first inspection of the newly registered service. The report says the previous provider had been rated Good in 2019.

What inspectors praised

  • Kind and respectful care

    People were treated with dignity and their differences, beliefs and choices were respected. Staff supported people to express their identity and maintain important relationships.

    “People's privacy and dignity was respected. Each person was valued as an individual and their differences and choices celebrated.” from the report

  • Communication through BSL

    Most staff, including agency staff, had basic British Sign Language training. Inspectors saw staff communicating with people using BSL and other methods.

    “Most staff, including agency staff had basic British Sign Language (BSL) training so they could communicate with people.” from the report

  • Enough staff and safe recruitment

    People and relatives said staffing had become more consistent. Recruitment checks included references from previous employment.

    “People were supported by enough staff to meet their needs and keep them safe.” from the report

  • Access to health support

    The home worked with health and social care professionals and arranged appointments when people’s health needs changed.

    “People were supported to access other health and social care professionals.” from the report
What inspectors were concerned about

  • Unlawful decision-making records

    serious

    Decisions for people who lacked capacity were not always recorded as least restrictive or in their best interests. Independent advocates had not always been considered.

    “People lacking capacity were not having decisions of consent made in line with statutory guidance.” from the report

  • Limited specialist training

    serious

    Staff had not received all the specialist training needed for people’s mental health, autism and positive behaviour support needs. This could lead to incorrect support when people became distressed.

    “Staff did not have adequate specialist training to proactively support people who could become distressed or upset.” from the report

  • Inconsistent care records

    needs fixing

    Care plans did not always reflect staff’s detailed knowledge of people. They lacked consistent information about goals, aspirations and communication needs.

    “Care plans were inconsistent and at times lacked key details.” from the report

  • Uneven access to activities

    needs fixing

    People had different experiences of going into the community. Staff shortages, changes in key workers and limited accessible transport had affected some opportunities.

    “People had mixed experience of how frequently they went into the community leading to a varied quality of life.” from the report
Questions to ask them, based on this report
  1. 01What specialist training have staff completed in autism, mental health and positive behaviour support since the inspection?
  2. 02How are best-interest and least restrictive decisions now recorded for people who lack capacity?
  3. 03How will you make sure each person’s care plan includes their communication needs, goals, preferences and aspirations?
  4. 04How will you ensure people have regular access to the community, activities and accessible transport?
  5. 05How do you check that Deprivation of Liberty Safeguards notifications and other legal requirements are completed on time?

This was the first inspection of the newly registered service and covered all five key questions, including infection prevention and control. This explanation was written from the published report of 31 August 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.

The story over the years

Every inspection of Gallaudet Home

4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.

  1. August 2023Requires improvementcurrent ratingdown from Good
    Safe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement

    Read what inspectors found at Gallaudet Home →

  2. January 2019Goodup from Requires improvement
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
  3. January 2018Requires improvementstayed Requires improvement
    Safe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
  4. July 2016Requires improvement
    Safe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
  5. June 2021

    Registered with the Care Quality Commission on 30 June 2021.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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