Archived: Progressive Mews

There were three people living in Acorn House and four people living in Blossom House when we inspected on 16 November 2016. This was an unannounced inspection.

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There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were appropriate arrangements in place to ensure people’s medicines were administered, obtained and stored safely.

People received support that was personalised to them and met their individual needs and wishes. People were encouraged to be as independent as possible but where additional support was needed this was provided respectfully. Staff respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner.

There were sufficient numbers of staff who had been recruited safely and who had the skills and knowledge to support people in the way they preferred. Staff had developed good relationships with people who used the service and understood the need to obtain consent when providing support.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse and staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care and there were procedures and processes which guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

People were encouraged to attend appointments with other health care professionals to maintain their health and well-being and the service worked closely with other agencies to meet people’s needs.

There was an open and transparent culture in the service and staff were very motivated. Staff understood their roles and responsibilities in providing safe, good quality care to the people who used the service. Processes were in place that encouraged feedback from people who used the service, relatives, and visiting professionals. An effective quality assurance system was in place and as a result the service continued to develop and improve.

We spoke with five members of staff including the registered manager.

We looked at two people's care records. Other records seen included: care plans and risk assessment reviews, complaints and compliments log, provider's safeguarding vulnerable adults from abuse policy and procedures, staff meeting minutes, staff training and supervision records, three staff personnel files, accidents and incidents log, health and safety audits, fire safety checks, maintenance logs and water temperatures.

We considered the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask; Is the service safe, Is the service effective, Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service a member of staff asked to see our identification and asked us to sign in the visitor's book. This meant that appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access the service.

Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications had needed to be submitted, we saw that policies and procedures were in place if they should be needed. The registered manager confirmed that relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people would have their rights protected.

Records seen confirmed that staff were booked onto upcoming or had received training in safeguarding vulnerable adults from abuse, the Mental Capacity Act (MCA) 2005 and DoLS. Guidance leaflets were available to staff explaining the principles of the MCA and DoLS in the staff training room. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

Safeguarding procedures were robust. Staff understood their role in safeguarding the people they supported.

There were effective policies and procedures for managing risk. Staff understood and consistently followed them to protect people.

Records confirmed health and safety was checked in the service and equipment was maintained and serviced.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Records showed that staff support was provided through effective training, supervision and appraisal.

Is the service caring?

Care was individual and centred on each person. One person told us, 'They (staff) support me and help me to do things for myself. I want to be more independent and I am getting there. I have a key worker (designated staff member) and they understand me. They (key worker) are good as they know when I want them to be around and when to leave me alone.'

Staff had a good understanding of the people's care and support needs and knew them well.

Staff interacted with people who used the service in a caring, respectful and professional manner.

Staff were skilled at responding to people who were not always able to express their needs verbally.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health and social care professionals, including a doctor, psychiatrist and social worker.

Is the service well-led?

Staff told us they were clear about their roles and responsibilities and were supported and trained to meet people's needs.

People's care records and risk assessments were accurate and up to date.

The provider had systems and procedures in place to monitor and assess the quality of the service provided. There were records to identify shortfalls in the service and how they had been addressed.