Sanctuary Supported Living (Bromley Care Services) was rated Requires Improvement overall, dropping from Good, with all five key questions rated Requires Improvement. Inspectors identified four regulatory breaches covering person-centred care, dignity and respect, consent (MCA) and good governance, alongside group-based rather than individualised support.
Concerns (13)
critical
Consent / capacity
: “The principles of MCA were not consistently followed. Assessments of people's capacity to make specific decisions...had not always been completed”
criticalPerson-centred care: “people's support needs were often planned on a group basis. For example, in relation to meal planning and activities these were mostly group based.”
criticalCare planning: “People had individual support plans but these did not always address all their needs...People had no recorded assessed goals or ambitions to work towards.”
criticalCultural competency: “There was no exploration of people's needs in relation to their protected characteristics such as their culture, sexuality or sexual orientation”
criticalGovernance: “The system for monitoring the quality of the service had not identified the issues and breaches of regulations we found at this inspection.”
moderateStaff training: “we found some gaps in refresher training and training for new staff in relation to specific areas such as the administration of some emergency medicines”
moderateStaff competency: “staff we spoke with were not all confident in its use following the training”
moderateInfection control: “the stair bannister at one site posed an infection risk due to peeling paint and woodwork and kitchen flooring at one site also required replacement”
moderateRecord keeping: “Accurate records of care were not in place as care plan records, key worker records and records of support did not reflect how people's needs...were met.”
moderateLeadership: “the provider's ethos was not evidently based around the 'Right support right care right culture' principles or current best practice”
minorStaffing levels: “Two relatives told us they did not think there were always enough staff. One relative said, 'I have found them short staffed.'”
minorComplaints handling: “one relative said they had complained about poor communication and felt that things had not really improved subsequently.”
minorCommunication with families: “relatives said they could not recall being asked formally for their views about how the service was run.”
Strengths
· Medicines were safely administered, managed, stored and audited regularly
· Staff understood safeguarding and how to recognise and report signs of abuse
· Staff knew people well and interacted with warmth, kindness and respect
· People were supported to access healthcare services and had hospital passports in place
· Lessons were learnt from safeguarding incidents and shared across services