The inspection took place on 23 and 24 May 2017 and the first day of the inspection was unannounced. We told the registered manager that we would be coming back the following day. At our previous inspection on 14 and 18 August 2015 we found the provider was in breach of two regulations relating to safe care and treatment and notifications, and the service was rated ‘Requires Improvement’. Nonoy Capina is a residential care home that provides support for five adults with learning disabilities. The home is privately owned and is located in a residential area. At the time of our inspection four people were living in the service.
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People received care and support from staff who had worked with them for a long period of time and were aware of how to meet their needs.
We observed positive interactions between people and staff, including the registered manager, throughout the inspection. People and their relatives told us staff were kind and compassionate and knew how to provide the care and support they required. All staff showed concern for people’s health and welfare in a caring and compassionate manner.
People were spoken with and treated in a respectful and kind way and staff respected their privacy and dignity, and promoted their independence.
Relatives told us they felt their family members were safe and staff had a good understanding of how to protect people from abuse. All staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns. Staff were confident that any concerns would be investigated and dealt with.
People’s risks were managed and care plans contained appropriate risk assessments with input from health and social care professionals, which were updated regularly when people’s needs changed. Staff worked closely with people and had a detailed understanding of how they could be aware and meet their needs.
People who required support with their medicines received them safely from staff who had completed training in the safe handling and administration of medicines. Staff completed appropriate records when they administered medicines and these were checked by staff and audited by the pharmacy to minimise medicines errors.
The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. Sufficient numbers of staff were employed to keep people safe and meet their needs.
Staff members were knowledgeable about their jobs as they had worked with people for over 15 years. They completed training on an annual basis to support them in meeting people’s needs effectively. Staff received regular supervision from management and told us they felt supported and were happy with their input during the supervision they received.
Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The provider had worked closely with the relevant health and social care professionals to ensure people’s liberty was not restricted in any way.
Staff were aware of the importance of asking people for consent and the need to have best interests meetings in relation to decisions where people did not have the capacity to consent.
People had regular access to healthcare services and staff made appropriate referrals if people’s needs changed. Staff worked closely with other health and social care professionals, such as the community learning disability team, occupational therapists and speech and language therapists . We saw evidence of this in communication records and people’s care plans.
Staff were aware of people’s dietary needs and food preferences and people were involved in decisions about the food they wanted to eat. People who needed support during mealtimes were supported by staff who had been given advice and guidance from health and social care professionals.
The provider made sure there was an accessible complaints procedure in place and people and their relatives knew how to make a complaint and were able to share their views and opinions about the service. There were also surveys in place and monthly house meetings to allow people and their relatives the opportunity to feedback about the care and support they received.
People were supported to follow their interests and encouraged to take part in a range of activities to increase their health and well-being. People were involved in planning how they were cared for and supported. Care records were person centred and developed to meet people’s individual needs and discussed when they had a review.
People and their relatives felt comfortable approaching the registered manager, who had a hands on role and was active throughout the service. Staff spoke highly of the working environment and the support they received from management. Staff were confident they could raise any issues or concerns, knowing they would be listened to and acted upon.
There were effective quality assurance systems in place to monitor the quality of the service provided and understand the experiences of people who used the service. The registered manager carried out a number of audits and checks on the service and learning took place from the result of them.