Archived: Salisbury Road

Updated 20 October 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 30 August and 1 September 2016 and was unannounced.

The inspection was carried out by one inspector.

We spoke with two care staff, two registered mangers as one registered manager from another service supported the first day of the inspection as the registered manager for the service was on leave and the deputy manager. We also spoke with two relatives and two people who used the service. We observed care in the service which included a financial handover.

We reviewed three staff files which included recruitment records, training, supervision and appraisal records. We reviewed three care plans.

Policies and procedures were also reviewed during the inspection which included safeguarding, whistleblowing, risk assessments, behavioural guidelines and medicine administration records.

We looked at other records which included quarterly audits, health and safety checks and incidents.

Updated 20 October 2016

The inspection took place on the 30 August and the 1 September 2016 and was unannounced.

At the last inspection the service was meeting the legal requirements.

Salisbury Road provides support with daily living, personal care, medicines and 24 hour accommodation for up to seven adults with a learning disability or an autism spectrum disorder.

The service 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.

The service was not monitoring the expiry date of medicines as we found two expired medicines in the medicine cupboard. There was no system to check that out of date medicine was removed so that people were not at risk of being given out of date medication. Staff also did not record when medicines were taken out of the service by people who went on leave this meant the balance of medicines could not be maintained accurately.

Medicines were administered safely, staff checked people's prescriptions and their medicines before administering. Records showed that two staff had to sign the medication administration record after the medicine had been taken.

People had appropriate risk assessments to protect them in the community and when at home. Staff knew people well and could explain people’s individual risks and what should be done to safeguard them.

Staff had received safeguarding training and were able to explain the process of escalating concerns. Staff advised they would always report any concerns to their manager or to the police, local authority and the Care Quality Commission (CQC).

Staff were recruited safely and the service ensured new staff had completed pre- employment checks before they were able to start work.

Staff also performed daily health and safety checks to keep people safe at the service, which included checking food temperature, fridge and freezer temperatures.

Staff received regular training which was eLearning based and in external classrooms. Staff were due to attend intervention training to keep the skills up to date.

Staff were well supported and received regular supervision with the registered manager. Records also confirmed that staff had their performance appraised annually. People’s relatives we spoke to told us that staff were good and had a lot of experience.

Deprivation of Liberty (DoLs) authorisations were lawful and the staff at the service knew who had them and what their conditions were. Records showed the registered manager was prompt in applying for extensions for people’s DoLS.

Staff demonstrated they understood the principles of the Mental Capacity Act 2005 (MCA 2005) and records showed that people had mental capacity assessments for different decisions they were unable to make. Staff we spoke to told us they supported people to make decisions by showing them pictures at mealtimes.

Staff were caring and treated people with dignity and respect. The service was proactive in helping people achieve their goals and the service recently supported someone to go on a holiday abroad to spend time with their family.

People had personalised care plans which detailed information about the person, their life history, skills and goals they wanted to achieve. To ensure they were being met people had a keyworker who they met with monthly to discuss progress towards their goals.

Staff were supported by the registered manager they thought was very good and took the time to listen to them and give advice.

Relatives at the service thought the registered manager was good and they told us they could approach them at any time if they had concerns. Relatives told us they would like more face to face meetings with other relatives and to have information sharing from the service’s head office.

Audits were carried out regularly every quarter to check the quality of the service.

A safeguarding notification had not been sent to the CQC as required and the registered manager was not aware this should be sent to us.

We found two breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.