INSPECTORS found that those attending a unit for people with a learning disability or autism in Stroud were looked after in 'unsafe' and 'unclean' flats. 

The Care Quality Commission (CQC) dropped the rating at Berkeley House, Cashes Green from good to inadequate following an inspection in October. 

Berkeley House, run by Gloucestershire Health & Care NHS Foundation Trust, is a stand-alone unit for autistic people or people with a learning disability, who have been detained under the Mental Health Act 1983.

Accommodation is arranged into seven individual flat and at the time of the inspection six of the flats were in use - one person was under 18 and five were over 18.  

This inspection was carried out in response to those concerns around the care and safety provided to people at Berkeley House.

The overall rating for Berkeley House has dropped from good to inadequate as have the ratings for safe and well-led.

The effecting rating dropped from outstanding to requires improvement and caring dropped from good to requires improvement.

This inspection didn’t rate how responsive the service was, so it remains as good from a previous inspection.

In their report, inspectors wrote that there was 'not a psychologist in place for two years', the service 'failed to review and monitor significant restrictive practices and consider how they could be reduced', staff members did not always 'safely follow the trust's medicines policy' and they did not always 'work well together to provide the planned care required for each person.' 

However, inspectors did find that 'people’s communication needs were met', their 'risks were assessed regularly', their 'care and support plans reflected their needs', staff ensured that 'people had regular contact with their families' and they 'had access to advocates when required.' 

Catherine Campbell, CQC’s director of operations in the south, said:  “Berkeley House needs to be doing more to redesign their service to help people avoid long stays in hospital.

"Autistic people and people with a learning disability, should be supported to live as independently as possible, and follow their interests and goals to support them to move adapt back into the community and to independent living.  

“Staff didn’t always encourage people to engage in hobbies or interests due to perceived risks and we found no detail in care plans about what people liked to do or what their personal goals were.

"For example, one person had not undertaken any activity for 14 days while another had only had six activities in 31 days.

"There was no evidence within their records to provide any rationale for this.

“Helping or encouraging people to live in their own home in the community helps to bring independence for the person living there.

“When we inspected the service, we also were very disappointed to find people being cared for in flats which were neither safe, clean, or well looked after.

"In fact, some flats needed major repairs with boarded up windows and doors.

“Staff were unnecessarily restricting people’s freedoms.

"They weren’t supported to leave the service and engage with the local community.

Stroud News and Journal: Berkeley House in Cashes Green has been rated as inadequate by CQC

"This meant that people in the service were not supported to be independent and have control over their own lives.

"The service seemed unaware how significant restrictions like this on people’s human rights and freedom could impact their wellbeing.

"Autistic people and people with a learning disability should have access to the same rights that most people are able to take for granted.

“The service was still not dignified for people which we highlighted as far back as 2022.

"Staff did not always follow the trust’s guidance when they observed people using CCTV cameras and the usage was excessive.

"Anyone could access the footage and we saw one person had five cameras in their flat with no real reason in their care plan about why this was needed.

“Immediately after the inspection we told the trust the areas where significant and rapid improvements are needed, and have been told the work has commenced on this.

"We will return to check this has been done and will continue to monitor the service while this happens.”

A spokesperson for the trust said: "The inspection outcome and downgrading of the unit is clearly deeply regrettable.

"Since the inspection, the majority of CQC recommendations have already been partially or completely resolved.

"We have also been working with NHS Gloucestershire as well as Gloucestershire County Council and NHS England Specialist Learning Disability support team to carry out further reviews and seek additional support on additional improvements being made.

"Our overall priority will always be the health and wellbeing of the people in our care. We are in regular contact with the families of the people being cared for at Berkeley House and we are supporting them throughout.

"We have been working with our partners for several years now to enable individuals to be discharged to more suitable environments as soon as and wherever possible.

"This work continues, and significant progress is being made, alongside work to redesign the wider support on offer for people with a similar level of need within Gloucestershire over the longer term. "