Archived: Turning Point - Ambleside

Turning Point- Ambleside provides accommodation for up to six people with learning and physical disabilities. The home is not registered to provide nursing care. At the time of the inspection there were five people living there.

The service did not have a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager had recently left the home and the team leader was providing management cover to the home with the support of an experienced registered manager and the regional manager.

People were supported by staff who knew how to recognise and respond to abuse. Relatives felt people were safe and risks were assessed with plans in place to mitigate these. People were supported by staff who were recruited safely and received training and supervision. People’s medicines were managed safely.

People were supported to make choices were they could and the staff worked in accordance with the principles of the Mental Capacity Act (2005). People had a variety of foods and were supported to maintain healthy and balanced diet. There was regular access to health and social care professionals.

People were treated with dignity and respect. Relatives told us that staff were kind. People and their relatives were encouraged to be involved in planning and reviewing there care and care was provided in a person centred way. Care records were held securely.

People received care that met their needs and care plans were clear and detailed so staff were able to provide care appropriately. There were activities available that suited people’s needs and people had opportunities to go out in the community and attended day centres regularly. There had been no recent complaints but relatives were comfortable to raise anything that concerned them.

There were quality assurance systems in place and these were used effectively. There were meetings for the team to share practice and changes and surveys to obtain relatives views. The home provided regular updates for people and communicated well to keep relatives informed.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Below is a summary of what we found during our inspection of Turning Point Ambleside on 23 April 2014.

Is the service safe?

People's needs had been assessed individually and were reviewed regularly by staff. Staff we spoke with were knowledgeable about people's individual requirements and how to support those needs. However we also found that the provider had not ensured people were protected from the risks of financial abuse. People who used the service may have been over charged for the purchase and use of a community mini bus under a lease scheme.

Health and safety audits were carried out by the manager on a regular basis as part of a system for monitoring people's safety. Where people had suffered an accident or been involved in an incident, the manager had reviewed these and implemented appropriate measures where necessary.

The home was welcoming and appropriately equipped to support the needs of people who lived there. We found the home was secure, and staff carried out a range of maintenance and safety checks frequently to ensure people's safety. However we also noted that some of the lounge and garden furniture required updating and replacing, and rubbish required disposal.

Is the service effective?

Staff promoted people's independence and ability to make choices as much as possible. Members of staff described a person-centred approach to care and demonstrated a good working knowledge of the contents of people's support plans. Suitable equipment was provided and maintained in order to promote people's independence.

People were protected from the risks of inadequate nutrition and dehydration. Care records we looked at assessed routinely people's fluid and nutritional intake, and where necessary people were referred for specialist professional support.

Is the service caring?

We observed that people were treated in a dignified and courteous manner by the staff. Staff we spoke with were aware of people's individual needs and responded accordingly. Where possible, people were supported to live as independently as possible. For example we noted that at lunch time, people were supported to eat their meal with the use of equipment that promoted their independence.

Is the service responsive?

People's support plans carefully described their preferences, likes and dislikes and these were reviewed regularly. Where a person's health needs had changed this prompted a review of their needs and referral to specialist health professionals where appropriate.

We found that when considering decisions for people who lacked capacity, staff had not followed the appropriate legal guidance. This meant that people's needs had not always been considered when making decisions about complex matters.

Is the service well-led?

The provider had an effective system to regularly assess and monitor the quality of service that people received. Members of staff were invited to attend meetings where they could raise any concerns and their feedback was listened to.

People who used the service were unable to provide their feed back to the provider in relation to the care they received. However the views of people's relatives had been sought, and where appropriate the manager had implemented appropriate changes.

The manager carried out a range of audits to ensure the service was effective and an action plan was developed from these. The regional manager visited the service frequently and carried out a series of checks to ensure that the quality of care was maintained and any actions from the audits were remedied.

We noted that a complaints policy was available to both visitors and relatives, and also an accessible format procedure was available to people who used the service. We saw from records that no complaints had been received in the last twelve months.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Where people were unable to communicate their needs we saw that people's relatives were involved in the development of care planning. One person's relative told us, "They are really good, they just seem to know [resident] and what they need. The whole team are really good and suit [relatives] needs as well as my own perfectly.'

There were suitable arrangements in place for the safe handling, and administration of medicines for people who used the services.

We reviewed the personnel files for two newly employed staff members and found that they were recruited with suitable skills and experience to provide support and care to vulnerable adults. The provider had also conducted checks to ensure that they were of suitable good character.

Staff members told us they received regular training and felt supported by their line manager. We saw from two personnel files we looked at that staff had received appropriate induction, training and development. One member of staff told us, "[Manager] is really supportive and is always there to help me."

We found that people's personal confidential records were held safely and securely and that records were accurate and fit for purpose.

None of people had the verbal ability to speak with us about their experience of living in this home, but we observed staff interactions with all five of them and checked documentation related to people's support and care they received. This showed us that people were respected, that their preferences were known to staff and respected and that they were cared for safely.