ABI Homes - Dyers Mews

ABI Homes – Dyers Mews, is a small residential care home providing personal care to up to 6 people with learning disabilities and autism. At the time of inspection, 5 people were living at the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the relevant documents and procedures had not always been followed to support this practice. We found that one person did not have a Deprivation of Liberty Safeguards (DoLS) procedure applied for, when aspects of their care were restrictive, in order to keep them safe.

Mental capacity assessments had been carried out to ensure people’s capacity was assessed and they could be as involved in their own care and decision making as much as possible. However, these assessments were not always clear, and contained conflicting information.

Audits were carried out across all areas of the service, but they were not always effective at finding fault and highlighting improvements needed. Errors and omissions with the Mental Capacity Act 2005 (MCA) assessments and DoLS procedures were not identified by audits.

People received safe care from a staff team who understood safeguarding procedures and were confident in raising concerns if needed. Staff told us that management took appropriate actions to safeguard people.

Risk assessments were in place to manage risks within people’s lives. This included positive behaviour plans for supporting people who may display behaviour which challenges. Staff were confident in supporting people in this area.

Safe recruitment procedures ensured that appropriate pre-employment checks were carried out, and staffing support matched the level of assessed needs within the service during our inspection. This included staffing people on a one to one basis at various times.

Medicines were stored and administered safely. Staff were trained to support people effectively and were supervised well and felt confident in their roles. People were able to choose the food and drink they wanted, and staff encouraged healthy options. Cultural requirements were understood and respected by staff.

Healthcare needs were met, and people had regular access to health and social care professionals as required.

Staff treated people with kindness, dignity and respect and spent time getting to know them. Care was personalised to each individual, and staff were passionate about supporting people to achieve independence where they could, and live full lives.

Care plans reflected people likes, dislikes and preferences. People were involved in activities that were important to them.

People and their family were involved in their own care planning as much as possible. An effective complaints system was in place.

The management team was open and honest, and worked in partnership with outside agencies to improve people’s support when required.

The service had a registered manager in place, and staff felt well supported by them and the wider management team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good, (14 July 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Abi Homes Dyers Mews provides accommodation and personal care to up to 5 people with learning disabilities and autism. The service was staffed at all times. At the time of our inspection the provider confirmed they were providing care to 4 people. At the last inspection, in March 2016, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. Staff were recruited appropriately and there were enough staff at the home to meet the needs of the people living at the service. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff were well supported by the management team with supervision, training and on-going professional development that they required to work effectively in their roles. People told us they were able to choose what they wanted to eat, and received the support they required within this area.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were well cared for and were treated with dignity and respect. We saw that care plans had been written in a personalised manner and enabled staff to provide consistent care and support in line with people's personal preferences. People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

The service was well run and had an open culture. At the time of inspection, the registered manager was not available; however staff were being supported by a deputy manager and other visiting managers from within the organisation. Staff told us that they had confidence in the management team and their ability to provide quality managerial oversight and leadership to the home.

This inspection took place on 03 March 2016 and was announced.

The inspection was carried out by one inspector.

Dyers Mews is a six bedded house situated in a residential area of Milton Keynes. It provides residential care for six people with Learning Disabilities and Autistic Spectrum Conditions. People who live at Dyers Mews are supported to live as independently as possible. On the day of our inspection five people were using the service.

There was a registered manger 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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and on-going training. They were well supported by the registered manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were very knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professional when required, including dentist, opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

This is a summary of what we found-

Is the service caring?

We observed that people appeared happy in their environment. Staff knew them well and were seen to offer reassurance and support.

Is the service responsive?

We saw that care plans had been reviewed and updated when people's needs changed. People were supported to enjoy activities of their choice.

Is the service safe?

There were enough staff on duty to meet the needs of the people living there, and management staff were available on call if required. People were cared for in an environment which was clean and safe.

Is the service effective?

People's needs were assessed and care planned and delivered to reflect this. An advocacy service was available if people needed it.

Is the service well lead?

There was a registered manager for the service, supported by an area manager and director of operations. Quality assurance processes were in place to ensure people received a quality service.

We spoke with members of staff that were knowledgeable about the needs of people who used the service, and we heard them speak to people in a kind and respectful way. We saw that staff received regular supervision and appraisal which ensured that they were supported and developed.

We were concerned that some people's records had not been reviewed to update care needs within the timescale set down by the provider.

We spoke with a relative of a person who used the service. When we asked them about how they found the service they told us "It's very good and the staff are all really nice". They told us that they thought to improve the service more activities and outings could be arranged in the evenings.

We spoke with two staff members who both told us that they felt well supported in their roles. One of the staff told us "It's an excellent service where we believe that we can make a difference and add value to people's lives".

We found that people's needs were assessed and there were detailed care plans in place to ensure that their needs were met. We saw that people's preferences and usual routines were recorded and that risks were assessed to ensure people's welfare and safety. We found that there were appropriate arrangements in place for the ordering, recording, storage, administration and disposal of medication. We found that there was an effective complaints system in place.

We had concerns that staff were not receiving regular supervisions and appraisals in their work.