We undertook an unannounced inspection of this service on 7 and 8 July 2016. The previous inspection took place on 3 December 2013 and found there were no breaches in the legal requirements at that time.The service is registered to provide accommodation and personal care for up to five people who have learning disabilities, including mental health and some complex and challenging physical needs.
Accommodation is provided in a detached house in a quiet residential area of St. Mary’s Bay. Accommodation is arranged over the ground floor and each person had their own bedroom. The home benefits from an enclosed back garden with wheelchair ramps and seating areas.
This service had a registered manager in post. A registered manager is a person who is 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.
At the time of inspection four people lived at the service. We met and spoke with each person. People told us that they liked living in the home, they were happy, they liked the staff and the staff were kind. They thought the home provided a safe, relaxed and comfortable living environment.
Our inspection found that whilst the service offered people a homely environment and their care needs were being supported; there were shortfalls in some areas that required improvement.
Arrangements did not ensure the correct storage of medicines and records for disposal of medicines were incomplete.
Items requiring replacement, maintenance or repair, although identified had not been completed and time scales were not set to ensure this happened.
People’s goals and wishes were not progressed to encourage development of learning and exploring new activities and challenges.
Authorisations and decisions, made under the Mental Capacity Act 2005 to deprive people of their liberty, were not notified to the Care Quality Commission when they needed to be.
The service had access to the local authority safeguarding protocols, and incidents that warranted referrals to the authority were made.
Quality assurance checks were not wholly effective in identifying some shortfalls or ensuring known concerns were progressed to their conclusion.
Checks ensured sufficient medicines were ordered, the right amount was given and that people received the right medicines when they were supposed to.
All staff had an understanding of the Mental Capacity Act 2005, and Deprivation of Liberty safeguards, they understood in what circumstances a person may need to be referred and when there was a need for best interest meetings to take place.
People told us that they felt safe in the service and when they were out with staff.
People had personalised records detailing their care and support, including well developed support plans for their health needs.
People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.
People, relatives and visiting professionals had opportunities to provide feedback about the service both informally and formally. Feedback received had been positive.
People felt the service was well-led. The registered manager worked alongside staff; they took action to address any concerns or issues straightaway to help ensure the service ran smoothly.
The provider had a set of values, which included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.
We found a number of breaches the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.