Powys House Residential Home

Updated 13 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

Powys House Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed the information, we had about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection-

We spoke with 11 people who used the service and three relatives about their experience of the care provided. We spoke with 10 members of staff including housekeepers, catering staff, care staff, the deputy manager and the registered manager. We spoke with three visiting health and social care professionals. We carried out observations of people's experiences throughout the inspection.

We reviewed a range of records. This included four people's care records and medication records. We looked at two staff files in relation to recruitment and four staff files in relation to staff supervision. Additionally, a variety of records relating to the management of the service, including accident and incident records and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed additional information sent to us by the registered manager and spoke with two professionals who regularly visit the service.

Updated 13 March 2020

About the service

Powys House Residential Home is a care home. Powys house is registered to provide accommodation and personal care for up to 18 people and supports people living with a learning disability and/or mental health needs. At the time of the inspection there were 17 people living at the service. The service was a large single house, which had been adapted to suit the needs of the people living there.

The service has been developed 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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 18 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the home being in a residential area close to local amenities and public transport. People were supported to be active members of their local community and used all local facilities either independently or with staff support. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Where we identified areas for improvement the management team took immediate action to address these. These included the absence of some risk assessments, systems to ensure the safety of prescribed topical creams had not been followed, bath and shower chairs were rusty and could therefore not be adequality cleaned. These could have adversely impacted on people’s safety and had not been identified by the provider’s and registered manager’s quality monitoring of the service.

The registered manager was not fully aware of their responsibilities under the duty of candour which requires the service to apologise, including in writing when adverse incidents have occurred.

CQC had not been notified of all significant events as required. Registered persons are required to notify CQC of a range of events which occur within services. Whilst we had been notified of some events we had not been notified of abuse or allegations of abuse which had occurred. The service had appropriately informed the local authority safeguarding team and taken reasonable action to reduce the risk of recurrence. Following the inspection, the registered manager informed us their systems had been amended to ensure that all necessary notifications would now be submitted, and the duty of candour would be followed correctly in the future.

People told us they were happy living at Powys House and felt supported to live their lives in the way they wished to do so. Staff were observed to treat people with kindness and compassion.

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; the policies and systems in the service supported this practice.

Staff supported people and showed an understanding of equality and diversity and people were treated with dignity, and their privacy was respected. People and their relatives were involved in the planning and review of their care and people were supported to be as independent as possible.

People and their relatives gave us positive feedback about their safety and told us that staff treated them well. Staff knew how to keep people safe from harm.

Staff were recruited safely, and sufficient numbers were employed to ensure people's care and social needs were met. Staff had received appropriate training and support to enable them to carry out their role safely.

Risk assessments and management plans were generally completed for people and the home environment to ensure safety. There was a system to manage accidents and incidents and to reduce them happening again.

People received their medicines safely and as prescribed.

People's needs were assessed to ensure these could be met by the service. The registered manager and staff worked with other external professionals to ensure people received effective care.

There was a clearly defined management structure and regular oversight and input from the provider’s representative. Staff were positive about the management of the service and told us the registered manager was very supportive and approachable. Any concerns or worries were listened to, addressed and used as opportunities to make continuous improvements to the service.

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 (published 27 June 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.