This inspection took place on 18 and 19 December 2015 and was unannounced. At the last inspection on 1 May 2014 we found the service was meeting the regulations we looked at.Support for Living Limited - 25/27 Haymill Close is a care home which provides accommodation and care for up to nine adults with a learning disability. At the time of our visit there were six people using the service.
The accommodation consists of two flats with three rooms each and is laid out over one floor.
Each person had their own bedroom and can access the communal facilities such as a lounge, dining room, kitchen and garden. The flat on the first floor had been converted into the staff office and was not used as living space. “We have requested that the registered manager submits a formal request to the Care Quality Commission to reduce the number of places offered from nine to six”.
There was a registered manager in place. 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.
During our visit we spoke to the deputy manager, area manager, three care workers and four family members. The registered manager was not available during our visit.
The majority of people using the service were unable to share their experiences with us due to their complex needs and ability to communicate verbally. So, in order to understand their experiences of using the service, we observed how they received care and support from staff. To do this we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We looked at records which included three people’s care records, training information, and other records relating to the management of the service. After the visit we contacted external professionals and asked them for their views and experiences of working with the service.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
There were systems in place to ensure safe medication administration, however these were not always effective and medication was not always safely administered and stored.
People were protected from harm and abuse. Staff had up to date safeguarding training and knew how to protect people if they suspected people were at risk of abuse.
Risks were regularly assessed and risk management plans were put in place to minimise the risk of harm and guarantee people’s safety.
There were systems in place to ensure people lived in a safe environment. Staff received relevant training and knew what to do in case of an emergency.
There was an effective and roust recruitment process in place which ensured that only staff who were suitable to work with people who used the service were appointed
Staffing levels were sufficient to meet people’s general needs. However, distribution of duties and skills amongst them were not always sufficient to meet the needs of people using the service. The management team were aware of the issue and were working towards resolving it.
Staff received in-depth training to ensure they had the knowledge and skills to support people using the service. The registered manager had systems in place to guarantee that staff’s personal development continued and that all training was up to date. Relatives told us they had confidence in staff and they were happy with the support offered to their family members.
Staff received ongoing support in the form of one to one supervision and regular team meetings.
Staff had a good awareness of the likes, dislikes of people using the service. Family members described them as “knowing everything about their loved ones”.
There were good links with external health professionals to ensure ongoing access to healthcare services.
The service met the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Where people did not have the capacity to consent to specific decisions staff involved relatives and other professionals to ensure that decisions were made in the best interests of the person and their rights were respected.
The service promoted person centred care that was visible in every aspect of support being offered. Individual care plans consisted of a detailed account of people’s needs and personal preferences. People using the service and their relatives were invited to contribute during care reviews.
The service was well led. It had a complaints policy and procedure in place and complaints were fully investigated. The provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.
The staff and relatives described the management team as robust and with a hands on approach