The Care Quality Commission (CQC) has rated Three C’s Support inadequate and placed it into special measures, following an inspection in September.
Three C’s Support provides supported living accommodation to young people and adults living with a learning disability or mental health needs. It supported 54 people across Hackney, Lewisham, Greenwich, Merton, and Newham at the time of this inspection.
CQC inspected in response to concerns people and local organisations raised about safeguarding failures and poor quality care at the service. This is the first inspection of Three C’s Support under the management of Choice Support. It was rated good under the previous owner.
CQC has rated the service inadequate for safe and well-led. It has rated it requires improvement for effective, caring and responsive.
CQC has placed the service into special measures, meaning it will be closely monitored to ensure people are safe while they make improvements. Special measures also provide a structured timeframe so services understand when they need to make improvements by, and what action CQC will take if this doesn’t happen.
CQC also told Choice Support it must provide an action plan, and monthly updates on the improvements they’re making.
Cat Eglinton, CQC deputy director of adult social care in south London, said:
“When we inspected Three C’s Support, we were deeply concerned to find leaders had extremely poor oversight of people’s care, which had exposed some to abuse and unsafe care. A shortage of frontline managers had disconnected the corporate leadership from the day-to-day situation in their supported living homes.
“Outside professionals highlighted multiple safeguarding concerns which the service hadn’t reported to the local authority or CQC, including financial abuse and inappropriate staff conduct. Because leaders failed to identify, report or thoroughly investigate these incidents, they didn’t learn from them to protect people in future.
“There also weren’t enough staff to meet people’s needs, and the existing staff lacked training and support from their leadership. While a small number of staff had exploited poor management oversight to mistreat people, we found the vast majority of staff were kind and well-intentioned. Most staff were working very hard for the people in their care, but their efforts were undermined by management failures.
“Staff couldn’t always care for people in dignified ways or support them to make daily choices, because of staffing shortages and mismanagement. We also heard four people couldn’t leave their home for eight months because a lift was broken, yet management hadn’t taken urgent action with the owner of the building.
“Likewise, some people’s care plans hadn’t been updated for at least ten years, meaning staff weren’t guided on how to meet their needs or manage risks to their safety.
“Inconsistent management meant people’s experiences varied significantly between homes. Choice Support has begun taking steps to drive improvement, but more needs to be done. Stable and consistent management will be essential to make and sustain the changes needed to improve people’s care.
“We’ve shared our findings with them and told them where they must make improvements. We will continue to closely monitor this service to ensure people are kept safe, including through further inspections.”
Inspectors also found:
- Some supported living homes were messy and dirty or had maintenance issues that could pose risks to people.
- The service didn’t ensure people had access to meaningful activities or work with them to set goals.
- Leaders didn’t always consider people’s views when making decisions. The service manager spoke of closing a supported living home some people had lived in for 22 years to save money, without considering their needs or preferences.
- The service didn’t always involve people in decisions about their own care and didn’t always encourage or enable people to give feedback.
- The service didn’t always respect religious needs. Staff didn’t provide one person with halal meat until it was raised as a safeguarding issue.
- Leaders overworked staff, some of whom routinely worked double their contracted hours, some seven days a week or up to 48 hours without breaks. This didn’t support staff to provide people good care.
However:
- Staff responded quickly and sensitively if people were uncomfortable or distressed.
- Staff knew how to communicate with the people in their care, including non-verbally.