This ‘comprehensive rated’ inspection of 24 Mountjoy Road took place on 10 August 2016 and was announced. At the last inspection on 7 February 2014 the service met all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These regulations were superseded on 1 April 2015 by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.Mountjoy Road is a care home that is part of the Bridgewood Trust and is registered to provide accommodation for people who require support with their personal care. It provides this service to a maximum of eight adults who may have a learning disability. The service is on a quiet residential road close to the centre of town, has access to local bus transport links and provides all single occupancy accommodation. There were six people using the service at the time of the inspection.
The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for almost six years. 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. The registered manager was unavailable on the day of the inspection, but the service was being managed by a senior staff member, who was assisted later in the day by two support workers.
People were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were also managed and reduced on an individual and group basis so that people avoided injury of harm wherever possible.
The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s need and we saw that rosters accurately cross referenced with the people that were on duty. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to care for and support vulnerable people. We found that the management of medication was safely carried out.
We saw that people were cared for and supported by qualified and competent staff that were regularly supervised and appraised regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.
Employees of the service had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. Where a person lacked capacity to make their own decisions the registered manager used the legislation to work with other health and social care professionals and family members to ensure a decision was made in the person’s best interests.
People received adequate nutrition and hydration to maintain their levels of health and wellbeing. The premises were suitable for providing care and support to people with a learning disability, as they were domestic, comfortable, well-furnished and pleasantly decorated.
We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook care and support tasks.
People’s wellbeing, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever possible. This ensured people were respected, that they felt satisfied and were empowered to take control of their lives.
We saw that people were supported according to their support plans, which reflected their needs well and which were regularly reviewed. People had many opportunities to engage in pastimes, activities and occupation if they wished to. People had very good family connections and support networks that staff supported them to maintain.
There was an effective complaint procedure in place and people were able to have any complaints investigated without bias. People that used the service, relatives and their friends were encouraged to maintain healthy relationships through frequent visits, telephone calls and sharing of information.
The service was well-led and people had the benefit of this because the culture and the management style of the service were positive and inclusive. There was an effective system in place for checking the quality of the service using audits, satisfaction surveys, meetings and good communication, but action planning for improvement of the service and feedback to stakeholders was insufficient. We made a recommendation regarding this.
People had opportunities to make their views known through direct discussion with the registered provider or the staff and through more formal complaint and quality monitoring formats. People were assured that recording systems used in the service protected their privacy and confidentiality as records were well maintained and were held securely in the premises.