Background to this inspection
Updated
28 January 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 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 November 2016 and was unannounced. The inspection team comprised of two adult social care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we looked at the information we held about the service including notifications they had sent us and information from the local authority.
During the visit, we spoke with two members of staff. We also spoke with one health and social care professional who was visiting the service on the day of the inspection.
We looked at care records for four people using the service and we talked with four people living at the service. We checked medicines storage and records related to medicines.
We looked around the premises including looking at four bedrooms occupied by people living at the service. We looked at records relating to food hygiene and maintenance of the service. We reviewed training records for the staff team and supervision records for five members of care staff. We also looked at the recruitment process for three of the staff.
After the visit we spoke with two relatives of people who use the service and another two health and social care professionals. We also spoke with the Director of the organisation.
Updated
28 January 2017
We inspected this service on 30 November 2016. The inspection was unannounced. Psychiatric Rehabilitation Association is a care home registered for a maximum of seven adults who have mental health needs. At the time of our inspection there were five people living at the service. The service is located in two large houses on the same street, 44 & 60 Chesterfield Gardens. Each house has two floors with access to a back garden.
We previously inspected the service on 30 August 2013 and the service was found to be meeting the standards inspected.
Whilst there was a registered manager at the service, the registered manager was away from work so there were temporary management arrangements in place. One staff member was temporarily promoted to supervise the home. The provider had also appointed a temporary service manager the week of the inspection who would oversee the running of the home, though was not based at the service.
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 living at the service told us they felt safe. People told us they found the staff caring and we witnessed kind interactions between staff and people living at the service on the day of the inspection.
Staff recruitment was not always safe as the provider could not evidence references had been applied for.
Although there were risk assessments in place which were updated regularly, they did not cover all the risks identified in the care plans and care records. Also, we found some were generic in nature so did not offer specific advise to staff in managing risks identified. Care plans were in place and had been updated regularly.
Staff supervision, appraisal and training took place.
We found medicines were stored and administered safely. However, not all staff were aware of the side effects of medicines.
The service was clean throughout and food was labelled and sealed hygienically. Accidents and incidents were recorded but we could not always evidence learning had taken place as a result, and was shared with the staff team.
We checked the system for managing people’s money. Receipts were available to show expenditure and there were spot checks of funds against records. There was a lack of evidence to explain the authority the service had to manage people’s money.
We noted one practice by the registered manager that lacked understanding of consent in relation to one person living at the service.
Some people living at the service told us they thought there was not always enough staff to support them. The provider told us agency staff were to be employed to fill any vacancies on the rota following the inspection, and they would review how staff were deployed across the houses.
Food was plentiful and people had an opportunity to choose the menu. People prepared their own breakfast and lunch if they were able, and staff cooked the evening meal.
People had some opportunities to be involved in their care through key worker sessions, and we saw that outings took place that had been chosen by people living at the service.
Fire drills took place regularly and there were checks of the premises for health and safety risks. There were some minor repairs required to the building and the décor was dated in some areas. Some furniture needed replacing in the communal areas.
We found breaches of the regulations in relation to staff recruitment, consent, risk assessments and governance of the service.
We have also made a recommendation in relation to personalisation of care records.
You can see what action we told the provider to take at the back of the full version of the report.