Archived: United Response - 14 Manor Road

Updated 21 December 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.

We inspected the service on 18, 22 September and 20 October 2017. We announced the inspection because the service is small we needed to ensure people would be available. Two inspectors visited on all days of inspection.

Before the inspection we reviewed all of the information we held about the service. This included information we received from statutory notifications since the last inspection. Notifications are when providers are required by law to send us information about certain changes, events or incidents that occur within the service. We sought feedback from the commissioners of the service, visiting professionals and North Yorkshire County Council prior to our visit. The provider completed a provider information return (PIR). 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. We used all of this information to plan our inspection.

At the time of our inspection visit there were four people who used the service. We spent time with all four people and spoke with three relatives. We spent time in the communal areas and observed how staff interacted with people and some people showed us their bedrooms. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

During the visit we spoke with the registered manager, area manager, quality manager, area director, two supporting managers and four members of staff who worked in the service. We spoke with four visiting professionals as part of the inspection.

During the inspection we reviewed a range of records. This included two people’s care records, including care planning documentation and medication records. We also looked at two staff files, including staff recruitment and training records, records relating to the management of the home and a variety of policies and procedures developed and implemented by the provider.

Updated 21 December 2017

We inspected United Response –14 Manor Road on 18, 22 September and 20 October 2017. We announced the inspection because of the small nature of the service we needed to ensure people would be available. At our last inspection in October 2015 the provider met all legal requirements and was rated Good overall.

United Response –14 Manor Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. United Response –14 Manor Road accommodates four people in one adapted building who had a learning disability and/or autism spectrum disorder with additional physical disabilities.

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.

A registered manager was 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. Following the inspection we were informed the registered manager had left the organisation. The provider has asked an experienced manager to oversee the service in the interim.

We were also informed the provider had made the decision to close the service. This was in part because of the challenges they had faced recruiting and retaining staff in the geographical area. The provider is working with the local authority to find appropriate services for each person.

We saw the systems in place to assess risk and manage safety were not robust. This included the assessment of people’s needs in areas such as mobility and falls. The systems the provider had in place to assess the quality and safety of the service were not effective because they had not picked up on all of the issues found at this inspection. Where they had highlighted areas of concern action had not always been taken to improve. This included an action identified following a safeguarding process. The provider listened to our feedback and has implemented new systems and processes since the inspection in these areas.

Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We saw medicines were managed well and staff were trained in this area.

We saw staff had received supervision on a regular basis and an appraisal. Staff training was well managed to ensure they received appropriate knowledge to enable them to fulfil their role. There were enough staff on shift to meet people’s needs and they had been recruited safely.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards, which meant they were working within the law to support people who may lack capacity to make their own decisions. Records to evidence such decisions were not always in place.

Positive interactions were seen between staff and the people who lived at the service. Staff knew how people communicated in their own way and we saw they used this knowledge to empower people to make their own choices. Staff behaved in a respectful manner and spoke about people in a caring way. People’s dignity was maintained and people were well cared for.

People were observed enjoying being included in day to day tasks such as food preparation and were supported to be independent where possible. People enjoyed their mealtime experience and we felt a real family atmosphere in the service.

People had their health needs recorded and staff followed advice from professionals to maintain their health. This included monitoring health and nutrition through regularly weighing people. We asked for a review of appointments needed for each person and this was organised quickly.

We saw people had hospital passports. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital.

Care plans were very person centred and written in a way to describe people’s care needs so that staff knew exactly how a person preferred to be supported. People and their families were involved in designing the care received.

People were supported to access the community and a wide range of activities including holidays. We saw they maintained relationships with people they cared about and staff supported this.

The provider had a system in place for responding to people’s concerns and complaints. All concerns raised had been acknowledged and the provider worked with the complainant to seek a solution.

Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found during this inspection. These related to safe care and treatment and good governance. You can see what action we told the provider to take at the end of this report.