This inspection took place on 14 and 15 November 2018 and was unannounced. At our last inspection in March 2018, the service was rated as ‘inadequate’ and the following concerns were raised: The provider had failed to ensure that staff consistently obtained people's consent before any care or treatment was provided. This resulted in a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection we found improvements had been made.
The provider had failed to ensure relevant health and safety concerns were included in people's care and treatment plans and that medical attention was consistently sought when people were unwell. This resulted in a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection we found improvements had been made.
The provider had failed to ensure service users were protected from abuse and improper treatment in accordance with this regulation. This resulted in a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection we found improvements had been made.
Systems and processes were not in place to effectively assess, monitor and mitigate the risks relating to the health, safety and welfare of people living at the home. This resulted in a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection we found improvements had been made but more work was required to ensure the systems and processes in place were embedded and sustainable.
Following the last inspection, we asked the provider to complete an action plan to show what actions they would take and by when, in order to improve the ratings of the key questions of Safe and Well Led, from inadequate to at least good. We also asked them to provide us with monthly reports outlining the actions taken and progress made against concerns raised. At this inspection, we found improvements had been made and systems and processes were in place to continue to monitor the delivery of care and support at the service.
Safeharbour 260 is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Safeharbour 260 accommodates up to six people in one adapted building. At the time of the inspection, four people were living at the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a new manager in post who was in the process of making an application to become registered manager of the service. 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.
This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. However, there remain some areas where improvements made need to be further embedded to evidence sustained improvement.
People were supported by a group of staff who had been trained to recognise signs of abuse and who understood their responsibilities to report on and act on any concerns. Staff were aware of the risks to people and were kept up to date in changes in people’s care needs. Recruitment processes were in place to ensure staff were safely recruited.
Systems were in place to ensure people received their medicines as prescribed. Staff had received training in how to administer medicines and had their competencies assessed.
Cleaning schedules were in place and aprons and gloves were available to staff to prevent the spread of infection.
Information regarding accidents, incidents, health and safeguarding concerns was collected and analysed on a regular basis to identify trends or lessons to be learnt. Action was taken using this information to improve service delivery and ensure people received safe and effective care and support.
Staff knew people well and had received and induction and training which provided them with the skills to support people safely and effectively. Staff felt supported in their role and were kept up to date with changes in people’s care needs. People were supported to choose what they had to eat and drink and make healthy choices where appropriate in order to maintain a balanced diet.
Staff were aware of people’s healthcare needs and how to support them to maintain good health. People had access to a variety of healthcare professionals and referrals were made quickly when health needs changes.
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. Staff routinely obtained people’s consent and offered them choices throughout their day.
Staff were described as kind and caring and treated people with dignity and respect. Staff supported people to express their views and be actively involved in making decisions about their care and support.
People were involved in the planning and development of their care. There were a variety of activities people were encouraged to participate in that were of particular interest to them, both in and outside the home. Staff were improving their knowledge of people’s preferences when it came to their interests and were working towards sourcing new areas of activity people for people to participate in.
There was a system in place to report, record and respond to complaints. People were confident that if they did raise concerns, they would be listened to.
Staff had worked hard to respond to the concerns raised during the last inspection and had implemented a number of systems and processes to enable them to meet people’s needs. A wide variety of audits were in place which provided the manager and members of staff with oversight of the service. Where audits identified areas of concern, or trends in reporting, actions were taken.
Staff were confident that they changes being introduced to the service were making a positive difference in service delivery. Staff felt supported and listened to and proud of the service. Relatives were complimentary of the service, the hard work put in by staff and the difference this had made to their loved one’s lives.