SignHealth Constance Way

SignHealth Constance Way is a residential care home which provides care and support for six deaf people who also have mental health needs. At the time of our inspection there were 6 people living at the service.

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

People and relatives shared positive feedback about the care provided and management of the service.

Overall, medicines were safely managed and people were supported to be as independent as possible with this area of their care. Risks to people's care were identified and well managed; and staff were knowledgeable about people's needs. However, we identified some examples where support being provided was not always recorded. People were supported by a consistent team who had the appropriate skills and training. We received mixed feedback in relation to staffing levels. Systems were in place to protect people from the risk of abuse and to manage any risks related to their care needs. Staff recruitment practices were safe. There were systems in place to minimise the risk of infection.

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 policies and systems in the service were not always being followed. We found the registered manager was following the principles of the MCA and had involved relevant professionals when making best interest decisions, however this was not always being recorded. We have made a recommendation in this area.

The providing was caring for people with learning disabilities but this was not included in their registration. We asked the provider to take appropriate action. Governance systems were in place to ensure the service were reviewed and checked regularly however we found some examples were these had not been fully effective. Care was designed and delivered in a person centred way and people were encouraged to be independent and be engaged in activities to enhance skills.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 19 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

SignHealth Constance Way provides care and support for six profoundly deaf people, who have additional needs due to some mental health problems. The service is run by a national charity. The home is situated close to Leeds City Centre and within walking distance of local facilities. The two storey accommodation has been designed around the needs of deaf people and is fully equipped for this purpose. One of the ground floor flats is also equipped to accommodate a wheelchair user.

The home had a registered manager. 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.

At the last inspection we found the service required improvements. At this inspection we found the service had now met those requirements.

Staff had a good understanding of their responsibilities in relation to keeping people safe from harm.

There were enough staff deployed to meet the needs of the people and the results of background checks on staff showed that they were suitably employed.

Medicines were administered and stored safely, however medicines records and audits required further scrutiny. The provider carried out assessments to ensure staff were competent to manage medicines.

Staff received regular refresher training to keep their skills and practice up to date.

People were involved in choosing their own foods and they were provided with a well-balanced diet. Staff promoted effective food hygiene practices and healthcare services were accessed to regularly monitor people's health.

The provider followed the legal requirements in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People told us they were listened to by helpful and kind staff.

People made their own decisions and choices about how they received their care. Staff understood how to meet people's individual needs and respected their privacy and dignity.

Care records were personalised and people's relatives were invited to reviews when people requested this.

Staff held regular meetings with people to discuss their individual needs and help them attain their goals.

Information about how to complain was available to meet people's communication needs and people told us they had no current concerns. People were confident any complaints they raised would be resolved.

Robust audits were carried out to identify shortfalls and improve the service. People and staff were content with how the home was run. The provider had involved people in how the service could be improved.

People who used the service and staff told us the manager was approachable, listened and was supportive to them. There were systems in place to monitor and improve the quality of the service provided.

SignHealth Constance Way provides care and support for six profoundly deaf people, who have additional needs due to some mental health needs. The service is a national charity. The home is situated close to Leeds City Centre and within walking distance of local facilities. The two storey accommodation has been designed around the needs of deaf people and is fully equipped for this purpose. One of the ground floor flats is also equipped to accommodate a wheelchair user. The outreach service also supports people to live independently.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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.

We looked at the policy file in the service which showed some policies were out of date and there was no system in place for auditing the service.

We found the management of some medicines was not always effective. We spoke to the registered manager about the importance of ensuring peoples medication was recorded in relation to date and time of topical creams when these had been opened. We saw a safety certificate was out of date.

We saw the complaint’s policy was available in the home and were told this was given to people who used the service and their relatives when they first began to use the service. However we found the complaints policy was last reviewed in 2012.

We looked at records relating to the personal care the service was providing and found care was well planned and reviews involved the people receiving care and their families.

At this inspection we found the provider had systems in place to protect people from the risk of harm. Staff understood how to keep people safe and knew the people they were supporting very well.

We found that people’s dietary needs were being met and staff encouraged people to eat a varied and balanced diet.

There was enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff were skilled and experienced to meet people’s needs because they received appropriate training, supervision and appraisal. However we found only one staff had completed training in relation to the Mental Capacity Act 2005.

Care was personalised and people were well supported. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. People received good support to make sure their nutritional and health needs were appropriately met.

We observed good interactions between staff and people who used the service and the atmosphere was relaxed. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.

People had detailed care and support plans relating to all aspects of their care needs. They contained a good level of information setting out exactly how each person should be supported that ensured their needs were met. People we spoke with told us they were happy with the care and support they received. One person told us, 'I like it here. They look after me very well.'

We observed people were cared for in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection. The people we spoke with told us they had no concerns with the cleanliness of the home.

We found people were supported by sufficient numbers of qualified, skilled and experienced staff which met people's needs. People who used the service we spoke with told us there were always enough staff to help them when they needed support.

There were quality monitoring programmes in place, which included people giving feedback about their care, support and treatment. This provided an overview of the quality of the services provided.