7 July 2016
During a routine inspection
Hamilton Court is a registered care service offering accommodation and support for up to seven adults who have a learning disability. At the time of our inspection six people were using the service. The accommodation is offered over two floors. There is a communal lounge, dining area and conservatory on the ground floor along with some of the bedrooms, and the remaining bedrooms are on the first floor. There is a large accessible garden for people to use should they wish to.
At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. It is a requirement that the service has 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.
People and their relatives felt safe with the support offered. Staff understood their responsibilities to support people to keep safe and to protect them from abuse and avoidable harm. The manager dealt with accidents and incidents appropriately. Risks to people’s health and well-being had been assessed. For example, where people could have shown behaviour that challenged, staff had guidance available which they followed.
People received support from staff who had been checked before they started to work for the provider. This had helped the provider to make safer recruitment decisions about the suitability of prospective staff. Relatives were satisfied with the number of staff available to support their family members and we found that staffing levels were suitable to help people to remain safe.
People received their medicines as prescribed in a safe way. Staff were trained in how to handle people’s medicines and knew what to do if an error was made. Medicines were stored appropriately and guidance was available and followed by staff about how people preferred to take them.
People were receiving support from staff who had the appropriate skills and knowledge. This was because staff received regular training. Staff had received an induction when they started to work for the provider so that they knew about their responsibilities. Staff met regularly with their supervisor to discuss their work and to receive feedback to support them to provide effective support to people.
People were supported in line with the Mental Capacity Act 2005 (MCA). People consented to their support where they could. The provider had assessed people’s mental capacity where this was necessary and made decisions in people’s best interests. Staff received training in the MCA, understood their responsibilities and were aware of the need to make applications to the appropriate body where they had sought to deprive a person of their liberties.
People chose what they ate and drank and were satisfied with what was offered to them. People had access to healthcare services when required, such as to their doctor. People made decisions about their health where they could and staff knew how to monitor their well-being.
People received support from staff who showed compassion and kindness. Staff protected their dignity and privacy and showed respect for people. This included the safe storage of their care records. Staff communicated in ways that were important to people and the provider had made information easier to read where this was needed. For example, pictures were used to aid people’s understanding. People were supported to be as independent as they wanted to be by staff who knew their abilities and preferences. Some people had been involved in decisions about their support and where this was not possible, people had information on advocacy services that could help them to speak up.
People or their representatives had contributed to the planning and review of their support. People, where they could, attended their annual review and contributed to checking that their support continued to meet their needs. People had support plans that were person-centred and staff based their support on people’s individual requirements. Staff knew about the people they were supporting including their interests and hobbies. People took part in activities of their own choosing including visiting local pubs and craft work.
People and their relatives knew how to make a complaint. The provider had a complaints policy in place that outlined what they would do should they receive a complaint.
People, their relatives and staff had opportunities to give feedback to the provider. The manager had taken action where necessary following the feedback received. For example, more activities had been offered to people. The managers had also arranged for quality checks of the service to take place to make sure that it was of a high standard. For example, checks on people’s medicines and observations of staff practice were taking place.
Staff told us that they were supported to undertake their role and we saw that the provider had processes in place to make sure that this occurred. Staff understood their responsibilities including reporting the unsafe or abusive practice of their colleagues should they have needed to.
There was a shared vision of the service by the manager and staff members. This included promoting people’s abilities and respecting their dignity. We found that the manager incorporated the aims and objectives of the service into their practice and were aware of their responsibilities.