Bright Opportunities Enabling Services was rated Requires Improvement overall, with breaches of Regulations 13, 17 and 18 relating to unlawful restrictions on liberty, inadequate governance and incomplete staff training. While people received compassionate care from a stable, kind staff team, MCA principles, dignity in records and incident learning processes were not consistently applied.
Concerns (11)
criticalSafeguarding: “The provider had not always ensured people were protected from unlawful deprivations on their liberty.”
criticalConsent / capacity
: “The provider was not always working in line with the MCA. People's capacity to make decisions was not always assessed. Decisions were made for people without lawful authority.”
criticalStaff training: “We found some staff had not completed training in learning disability awareness, autism and mental capacity and were supporting people with these needs.”
criticalStaff competency: “Where staff had not passed the competency assessment at the end of the training course, they continued to support people without supervision.”
criticalGovernance: “The provider had not always ensured there were systems and processes to assess, monitor and improve the quality and safety of the service.”
moderateIncident learning: “There was no formal review of incidents and no actions recorded to demonstrate the provider had done all they could to reduce risks in future.”
moderateCare planning: “The provider had not always ensured that people's care records contained clear guidance for staff about how to support people effectively.”
moderateMedication management: “when people took medicines on an as and when basis (PRN) there were not always protocols to guide staff as to how to recognise when these may be required.”
moderatePerson-centred care: “people's dignity was not always promoted when people displayed behaviours that were normal for them.”
moderateRecord keeping: “staff, the registered manager and company director had documented a person's behaviours and their response to these in an undignified way.”
moderateLeadership: “the registered manager had not recognised the requirement for applications to the court of protection, mental capacity assessments or best interest decision records.”
Strengths
· Low staff turnover providing consistent care from staff who knew people well
· Effective infection prevention and control measures with appropriate PPE use
· Safe recruitment practices including pre-employment and DBS checks
· Sufficient staffing levels with one-to-one support as required
· Culture of openness, transparency and honesty reported by relatives, staff and professionals
Quality-Statement breakdown (14)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
safe: Using medicines safelyNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Assessing people's needs and choices; delivering care in line with standardsNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated