Background to this inspection
Updated
30 June 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on the 2 June 2016 and was announced. Twenty four hours’ notice of the inspection was given because the service is small and people and staff may be out doing activities. We needed to be sure they would be in. One inspector undertook this inspection.
Prior to the inspection we reviewed the information we held about the service, such as previous inspection reports and notifications we had received. A notification is information about important events, which the service is required to send us by law.
People who lived at the home had limited verbal communication, and were therefore unable to tell us about their experience of living at the home or about the care they received. We spent time in the communal parts of the home observing how people spent their day as well as observing the care being provided by the staff team.
The registered manager was available throughout the inspection. As well as the registered manager, we also spoke with three members of the staff team.
We looked at the records of three people who lived in the home. These included, support plans, risk assessments, health records and daily monitoring reports. We looked at some policies and procedures associated with the running of the service and other records including incident reports, quality audits and medicines records.
We spoke to two professionals who had been involved with the service, and a friend of a person who lived in the home.
Updated
30 June 2016
The inspection took place on the 2 June 2016 and was announced.
97 Monmouth Road provides care and accommodation for up to three people. On the day of the inspection three people were living at the home. The service provides care for people with a learning disability and associated conditions such as Autism.
The service had 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.
The atmosphere in the home was warm and welcoming. We saw people laughing and smiling and the interactions showed people had formed positive and trusting relationships with the staff supporting them. Professionals from the Learning Disability service were very positive about the care provided by staff. They said they felt the registered manager had worked hard to recruit a good, caring staff team.
There was a positive culture within the service. The registered manager had clear visions, values and enthusiasm about how they wished the service to be provided and these values were shared by the whole staff team. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they cared for people. Individualised care was central to the homes philosophy and staff demonstrated they understood and practiced this when meeting people’s support needs. They spoke in a compassionate and caring way about the people they supported.
There were sufficient numbers of staff to meet people’s needs and to keep them safe. Staff said they were well supported and had opportunities to discuss and reflect on practice. People received care and support from staff who knew them well and who had the skills and training to meet their needs. There was a strong emphasis on training and continuing professional development throughout the staff team.
Staff were supported to understand and manage people’s behaviours in an appropriate and lawful way. Training was provided and guidelines were in place to help staff identify possible triggers as well as what action to take if difficult or challenging behaviour occurred. We saw staff managed behaviours in a calm manner, providing reassurance and distraction to prevent situations from escalating.
People’s support plans included clear and detailed information about people’s specific needs and preferences. Staff were familiar with this information and could tell us in detail about people’s daily routines and how they liked to be supported. People had their health and dietary needs met. Staff monitored people’s health and well-being and supported people to access health services when required. People had their medicines managed safely, and received their medicines in a way they chose and preferred.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes are looked after in a way that does not inappropriately restrict their freedom. The manager and staff demonstrated a good understanding of the Mental Capacity Act 2005. People were supported where possible to make everyday choices such as what they wanted to wear, eat and how to spend their time. The manager was aware of the correct procedures to follow when people did not have the capacity to make decisions for themselves and if safeguards were required, which could restrict them of their freedom and liberty.
People were supported to lead a full and active lifestyle. Activities and people’s daily routines were personalised and dependent on people’s particular choices and interests. Staff recognised the importance of family and friends and supported people to maintain these relationships.
A system was in place to regularly review the quality of the service. This included a range of regular audits of people’s medicines, personal finances and the environment. Learning from incidents, feedback, concerns and complaints were used to aid learning and help drive continuous improvement across the service.