Archived: Santa Care

At our last inspection we rated the service good. At this inspection on the 7 March 2018 we found the service remained Good. Evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This service does not require a registered manager as the regulated activity accommodation and personal care is carried on by an individual who is registered with us in their own name. The individual Santa Bapoo is in charge of day to day activity carried out by the service.

Arrangements were in place to keep people safe. Staff knew how to identify abuse and understood the safeguarding procedures they needed to follow to protect people from abuse.

Risks to people's health and well-being were identified, assessed and managed as part of their plan of care and support. Appropriate risk management systems were in place. Staff understood their responsibilities to deliver safe care and to report all concerns to do with people’s safety or poor practise.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Arrangements were in place to ensure that people received their prescribed medicines. People’s dietary needs and preferences were understood and supported by the service.

People received personalised care and staff were responsive to people’s needs. People's care plans reflected people’s individual preferences and needs. They contained the information staff required to provide people with the care and support they needed in the way that they wanted. People were supported to be fully involved in decisions about their care.

Staff had a caring approach to their work and understood the importance of treating people with dignity and protecting people's privacy. People’s confidentiality was maintained.

People took part in a range of activities, and staff supported them to develop and maintain their daily living skills.

Staff received the training and support that they needed to provide people with individualised care and support. The provider ensured staff had the skills and knowledge to meet people's needs. Appropriate recruitment procedures were in place to ensure that only suitable staff were employed to provide care.

People and their relatives knew how to make a complaint and were confident their concerns would be addressed appropriately by the provider.

There were systems in place to assess, monitor and improve the quality of the services provided for people.

The provider worked closely with healthcare and social care agencies to ensure people’s needs were met and that improvements to the service and people’s care were made when needed.

We have made one recommendation about the use of CCTV in the home.

Further information is in the detailed findings below.

Santa Care is registered to provide accommodation and personal care for four adults. The home provides care for people who have a learning disability and/or mental health needs. The home is owned and managed by Santa Bapoo, an individual who owns two other care homes in North West London. There is no requirement for a separate registered manager. On the day of our visit there were four people living in the home. Public transport and a range of shops are located within walking distance.

People were treated with respect and staff engaged with people in a friendly and courteous manner. Throughout our visit we observed caring and supportive relationships between staff and people using the service. People told us staff were kind to them. People’s privacy and dignity were respected.

There were procedures for safeguarding people. Staff knew how to safeguard the people they supported and cared for. Arrangements were in place to make sure sufficient numbers of skilled staff were deployed at all times. People’s individual needs and risks were identified and managed as part of their plan of care and support to minimise the likelihood of harm.

Care plans were personalised and reflected people’s current needs. They contained the information staff needed to provide people with the care and support they wanted and required. People had the opportunity to participate in a range of activities of their choice.

People were encouraged and supported to make decisions for themselves whenever possible and their independence was maintained and promoted. People were provided with the support they needed to maintain links with their family and friends.

People were supported to maintain good health and their well-being was promoted. They had access to appropriate healthcare services that monitored their health and provided people with appropriate support, treatment and specialist advice when needed. People were provided with a choice of food and drink which met their preferences and dietary needs.

Staff were appropriately recruited, trained and supported to provide people with individualised care and support. Staff told us they enjoyed working in the home and received the support and training they needed to carry out their roles and responsibilities.

Staff understood the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They knew about the systems in place for making decisions in people’s best interest when they were unable to make one or more decisions about their care and/or other aspects of their lives.

People had opportunities to feedback about the service. There were systems in place to regularly assess, monitor and improve the quality of the services provided for people.

We spoke with two members of staff, including the Registered Manager. We looked at care records for the four people who used the service, and we checked the arrangements for hand washing hygiene.

We spoke with the four people who used the service, but they did not discuss with us any concerns about making decisions, cleanliness and staffing.

Mental capacity assessments had been carried out for each of the people who used the service for their understanding and ability to make decisions about their finances and any medical treatment. There was a clear audit procedure to show that the Registered Manager managed and recorded personal finances for two people appropriately.

We observed that the home was clean and that an appropriate standard of hygiene was maintained in the kitchen and bathrooms. Liquid soap was available and hand towel dispensers had been installed by the hand wash basins in the kitchen and in the toilet used by staff. Staff were aware of the procedures for effective hand hygiene in order to prevent the spread of infection.

No staff had been employed since our last inspection. At the last inspection we checked the files for three members of staff and noted that they held evidence to confirm that appropriate checks had been carried out before staff began work. One person who did not have confirmation of their good character and fitness to work with vulnerable people no longer worked in the home.

One person who we spoke with told us that they went to work at the day care centre. They said 'I do gardening. This is my job.'

Staff were aware of the nutritional needs of the people they supported. Everyone in the home was assessed regularly for the risk of malnutrition.

The Registered Manager told us that they managed the personal finances of all three people who used the service. However there was no evidence of capacity assessments and of decisions made about finances in each person's best interests as required by the Mental Capacity Act (2005) (MCA).

The provider did not have a written procedure for infection control. We observed that the home was clean. However there were no written instructions on the need for hand washing and the procedures for effective hand washing in the kitchen and in the toilet used by staff. There were no paper towels available at the hand wash basins so that staff could dry their hands as required by the Department of Health Code of Practice on prevention and control of infections.

Employment checks and training were not in place for all staff. The file for a family member of the provider who worked at the service showed that they did not have a criminal record check, evidence of identity, or appropriate references. They had not completed updates of essential training.

Each person had a comprehensive needs' assessment and care plans that took into account their individual preferences and likes and dislikes. These described the person's needs in detail and the action for staff to take to meet these. People were also supported with their healthcare needs. Staff ensured people attended their appointments with various healthcare professionals as planned and followed the instructions given by the healthcare professionals to make sure people received the treatment planned for them.

Where people were being supported to be independent and to be involved in the local community appropriate risk assessments were in place which showed that they were cared for and supported in a manner that ensured their safety without putting unnecessary restrictions on their independence. Care records also showed that staff supported people to maintain contact with their relatives. They kept people's relatives informed when there were changes in people's conditions and whenever possible involved them in the care of people.