Archived: United Response - 85 St Anne's Road East

Updated 6 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection of United Response - 85 St Anne’s Road East took place on 20 June and 03 July 2017. The first day was unannounced and the second day announced. The inspection team consisted of an adult social care inspector.

The inspection was prompted in part by notification of an incident following which a service user died. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident.

However the information shared with CQC about the incident indicated potential concerns about the management of health issues. This inspection examined those risks.

Before our inspection we reviewed the information we held on the service. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people the service supported. To assist in the planning of the inspection, we also contacted the local commissioning authority to gain their feedback about the care people received. This helped us to gain a balanced overview of what people experienced accessing the service.

We reviewed the Provider Information Record (PIR) we received prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This provided us with information and numerical data about the operation of the service. We used this information to guide us as to what areas we would focus on as part of our inspection.

People who lived at 85 St Annes Road East had limited verbal communication and were unable to hold an in-depth conversation with us. We spoke with or observed staff interactions with all three people who lived at the home. We also spoke with a senior manager, and five staff members. Prior to our inspection visit we contacted the commissioning department at the local authority and Healthwatch Lancashire. This helped us to gain a balanced overview of what people experienced accessing the service.

During our inspection we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with the people in their care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at care and support records of two people, the services training and recruitment and supervision records of two staff members, arrangements for meal provision, records relating to the management of the home and checked staffing levels. We also looked around the building to ensure it was clean, hygienic and a safe place for people to live.

Updated 6 September 2017

United Response - 85 St Anne’s Road East is registered to provide accommodation for six people who require personal care. The home is a semi-detached three-storey house providing good access to local services and amenities. Each person has their own bedroom and shares communal facilities.

This inspection visit took place on 20 June and 03 July 2017. The first day was unannounced and the second day announced. The inspection was prompted in part by notification of an incident following which a service user died. This incident is subject to a separate criminal investigation and as a result this inspection did not examine the circumstances of the incident. However the information shared with CQC about the incident indicated potential concerns about the management of health issues. This inspection examined those risks.

At the last comprehensive inspection on 25 February and 8 March 2016 we found breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had failed to ensure staff were working in accordance with the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS) legislation and failed to operate and implement effective arrangements to monitor safety and quality across the service.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We carried out a focused inspection visit on 13 April 2017 to review action taken in relation to the breaches. We saw the service had made improvements and were no longer in breach of the regulations. Staff were working in accordance with MCA and DoLS.

At our inspection on 20 June and 03 July 2017 we saw staff were aware of safeguarding procedures and knew the action to take to protect people from the risk of abuse.

Risk assessments were in place which provided guidance for staff. This reduced risks to people.

Although people had limited verbal communication we were able to speak with them and observe staff interaction with them. They told us they felt safe with staff, and liked the staff who supported them. One person told us, "I do feel safe here." They said staff were kind and friendly.

Medicines were stored securely, administered as prescribed and disposed of appropriately.

There were sufficient staff available to provide personal care and individual social and leisure activities. Staff received training to carry out their role and were knowledgeable how to support and care for people. They had the skills, knowledge and experience to provide safe and effective support.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

People told us they were happy with the variety and choice of meals available to them.

Care plans were personalised detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in making decisions about their care. Their consent and agreement had been sought before providing care.

People who used the service or their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise any concerns.

Senior staff monitored the support staff provided to people. They checked staff supported people in the way people wanted. Audits of care and support records and risk assessments were carried out regularly. People and their relatives were encouraged to complete surveys about the quality of their care.