Southside Partnership - 94 Strathleven Road

Southside Partnership - 94 Strathleven Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. A Housing Association (landlord) owned the building and as the landlord were responsible for its maintenance.

This service supported people with learning disabilities and/or autism, physical disabilities and communication needs. The care home was registered to care for six adults in one adapted building. At the time of our inspection six people were living at the care home.

People’s experience of using this service:

The service applied the principles and values of Registering the Right Support and other best practice guidance. This ensured people who lived at the service could live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

At this inspection the evidence we found continued to support the rating of ‘Good’ and there was no information from our inspection and on-going monitoring that demonstrated any serious risks or concerns.

However, although we rated the service ‘Good’ overall and for four out of the five key questions, ‘Is the service safe, caring, responsive and well-led?’; we found the service was not always effective. Therefore, we have rated them ‘Requires Improvement’ for the one key question, ‘Is the service effective?’

Although the care home was suitably adapted and designed to meet the physical disability needs of people living there; we saw the interior decoration had not been well-maintained. This was confirmed by discussions we had with visitors to the care home and managers and staff who worked there.

This quote from a relative summed up how most people felt about the care home, “I think my [family member] receives some really good care from excellent staff who work at 94 Strathleven Road, but I just wish they [provider] would do the place up a bit.”

We discussed this issue with the registered manager. They told us they had repeatedly raised their concerns about the homes poor decorative state with the House Association. At this inspection we saw recorded evidence that showed the Housing Association had recently agreed to the providers requests to refurbish all the care homes damaged bathroom/toilets and kitchen, as well as redecorate all the communal areas, by June 2019.

Progress made by the provider in partnership with the housing Association to achieve this time specific aim will be assessed at their next inspection.

The premises issues described above notwithstanding, people seemed happy at the care home. We observed good interactions between people living there and staff throughout our two-day inspection.

The service had appropriate safeguarding policies and procedures in place and staff had a clear understanding of these procedures. Risks to people had been assessed and was regularly reviewed to ensure people’s needs were safely met. This meant people were protected from avoidable harm, discrimination and abuse.

Appropriate staff recruitment checks took place before staff started working for the service. There were enough staff available to meet people’s care and support needs. People received care from staff who were suitably trained and supported to meet their personal care and support needs.

The service had procedures in place to keep the care home clean and reduce the risk of the spread of infection.

People were receiving their medicines as prescribed. Medicines were monitored and safely managed in line with best practice guidance.

Staff routinely sought the consent of the people they supported ensuring they had maximum choice and control of their lives. People were supported to do as much as they could and wanted to do for themselves to help them maintain and develop their independent living skills.

People were supported to maintain a nutritionally balanced diet. People received the support they needed to stay healthy and to access health care services as and when required.

People received support from staff who were kind and compassionate. Staff treated people they supported with dignity and respect. Staff also ensured people's privacy was always maintained, particularly when they supported people with their personal care needs.

Staff understood people’s preferred method of communication and acted on their wishes.

Staff met people’s spiritual and cultural needs and wishes. Staff understood people’s preferred method of communication and acted on their requests.

People’s care plans were personalised and routinely reviewed to ensure they remained up to date.

People were supported to participate in activities within the care home and in the wider community that reflected their social interests.

No one living in the care home at the time of our inspection required support with end of life care, however there were procedures in place to make sure people had access to this type of care if it was required.

The service was well-led and management support was always available for staff when they needed it. There was an open and transparent and person-centred culture.

The provider had effective systems in place to assess and monitor the quality and safety of the care and support people living in the care home received. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.

People, their relatives, professional health and social care representatives and staff were all asked to share their feedback about the service and action was taken in response to this feedback. People, and where appropriate their relatives and professional representatives, were supported to express their views and be involved in making decisions about the care and support they received.

People's concerns and complaints were dealt with by the provider in an appropriate and timely way.

The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver an effective care home service.

Rating at the last inspection:

Good overall and for all five key questions, ‘Is the service safe, effective, caring, responsive and well-led?’ (Report was published on 09 November 2016).

Why we inspected:

This unannounced comprehensive inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

All services rated "Good" overall are re-inspected by the CQC within two and a half years of the published date of our last planned comprehensive inspection.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates in keeping with our inspection methodology (See above).

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

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.

We last carried out a comprehensive inspection of this service in August 2015 and we found a breach of regulation.

We carried out an unannounced comprehensive inspection on 19 October 2016 to check on areas of concern identified at the previous inspection. This report covers our findings at the inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Southside Partnership – 94 Strathleven Road on our website at www.cqc.org.uk

People were safe at the service. Staff were kind and treated people with respect. We saw positive and friendly interactions between staff and people. There were suitable numbers of staff on duty to meet people’s needs.

The registered manager identified and assessed potential risks to people’s safety and put plans in place to reduce risks to people. There were regular reviews of risk assessments which ensured support plans were accurate and up to date.

People were supported in line with the principles of the Mental Capacity Act 2005 and the requirements of the Deprivation of Liberty Safeguards. Staff understood they would presume a person could make their own decisions about their care and treatment in the first instance. Staff supported people to make choices about their care.

People received their medicines safely and in line with good practice. The provider’s audit ensured staff accounted for all the medicines each person received and how stock balances.

The registered manager ensured staff understood their role and responsibilities. Staff felt well supported to develop their skills and knowledge to meet people’s needs. Staff received regular supervision and appraisal to ensure they met people’s needs. Staff discussed their learning and development needs and received in-house and external training to address any knowledge gaps.

People had a choice of meals and enjoyed the food provided at the service. People had access to healthcare professionals as and when needed. Staff responded appropriately and quickly when people’s health needs changed.

People and their relatives felt the registered manager considered their views in order to improve service delivery. People told us staff listened to them and respected their choices and decisions.

People, relatives and healthcare professionals were positive about the registered manager. There was an open atmosphere within the service. Management encouraged a culture of learning and staff development.

The registered manager and provider reviewed the quality of the service and took action to address any areas requiring improvement. The service worked closely with external stakeholders to keep the service abreast of developments in the care sector and to improve the quality of care people received at the service.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

During our inspection we spoke with the registered manager, four support workers, a communication development manager, two relatives and one person who used the service. We were unable to consult with five people who used the service about their care. This was because we were unable to effectively communicate with them. However, staff assisted us to understand how people communicated and how they felt at the time of our inspection.

Is the service safe?

The building provided a safe and suitable environment for people who used the service. The lounge, bedrooms and en-suite bathrooms had recently been decorated and the communal hallway was due to be re-decorated. The provider had ensured equipment was available for people's use. For example, we found people had been assisted to make their bedrooms appropriate for their needs and hoists were provided where required. There was a safe and accessible garden which people enjoyed on the day of our inspection.

People were protected from the risk of abuse and neglect. Staff were trained in safeguarding, were knowledgeable about the different forms of abuse and knew who to contact in the event of a safeguarding issue.

There were systems in place that ensured the team leader and staff learned from events such as incidents, accidents, complaints and investigations. There was evidence that learning from incidents took place and appropriate changes were implemented. Incidents

had been properly documented and acted upon.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at six people's person centred plans and found people's care needs were assessed by a multi-disciplinary team. People had personalised care plans which outlined their needs and gave a detailed description of how staff supported them. We spoke with staff who knew how to prevent risks from occurring with people they were supporting on the day of our inspection. We found people had risk assessments and action plans in place which were reviewed regularly by the manager.

We spoke with a communication development manager who confirmed the staff were involved with learning new methods of communicating with people who used the service. We saw a communication activity taking place on the day of our inspection which involved people and support workers.

There were systems in place to ensure staff received mandatory and specialist training to support people who used the service.

Is the service caring?

We observed people being cared for and spoken to in a kind and understanding manner. One person who used the service indicated the staff were kind to them. People's privacy and dignity were respected. We observed staff speaking to people with respect and kindness. We observed people's needs and wishes being met in a timely manner by staff. A relative we spoke with told us, "the staff are very loving."

We found people had been consulted on how they would like their bedroom to be decorated. For example, one person had all their favourite things written in calligraphy on the wall of their room. Another person was about to have their bedroom painted in the colours of their favourite football team at their choice. We noted fresh flowers in the communal lounge for people to enjoy.

Is the service responsive?

The service had an accident and incident folder which contained an accident/incident form for people who used the service or their relatives to complete if necessary with help from their link worker. We saw the complaints procedure was next due for review in 2015. We noted that no complaints about people's care and welfare had been received since our last inspection in May 2013. We spoke with a relative who told us they knew who to complain to if they had a concern.

Is the service well-led?

The service had quality assurance audits and systems in place. The team leader told us and we saw evidence of monthly staff meetings which covered areas which affected both people who used the service and staff. The staff received regular supervision which focussed on their development to encourage good practice. The registered manager for the service showed us information about the provider's 'Working Together for Change Event'. Following this event a staff stress survey had been developed which had been devised by the provider following meetings with staff. Staff we spoke with confirmed they had received this survey. This meant the service's staff had an opportunity to be listened to.

The majority of people living at the service were unable to contribute directly to the inspection because of the nature of their disabilities. As well as observing their interaction and activities we contacted five people with an interest in the service through involvement with people who lived there. Two of these people responded to our request for information. One person said "care needs are well met". We were told by one person that generally people are "able to direct and follow their interests" but felt that further effort was needed to use communication systems effectively. Another person felt that people needed further support with activities.

We spoke with five members of staff during our visit. One told us they felt the people had a good programme of activities that they enjoyed. Staff said that they enjoyed their work and felt supported.

We found that some aspects of the building needed attention to improve its appearance and homeliness. We were told that people had been assisted to make their bedrooms appropriate for their needs. There was a safe and accessible garden which people enjoyed on the day of our visit.