5 and 10 June 2015
During a routine inspection
We inspected Mount Road on 5 and 10 June 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
We last inspected the home on 9 April 2014 and found it met the five outcomes we reviewed.
Mount Road is a small service providing accommodation and personal care for three people with learning disabilities. It is a terraced house situated close to local shops and amenities.
The home had a registered manager in place and they have run the home for over 13 years. 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.
At the time of the inspection three people lived at the home and we met all of the people who used the service. Two of the people were able to tell us their views about the home. They told us they found that the service was exceptionally good, that the staff were fantastic, the home met all of their needs and they were kept safe.
We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.
We observed that staff had developed very positive relationships with the people who used the service. Staff were kind and respectful. We saw that they were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff but they found staff provided really helpful advice.
People told us they were offered plenty to eat and assisted to select healthy food and drinks which helped to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to manage their weight and nutritional needs.
We saw that people were supported to maintain good health and accessed a range of healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. We saw that people had hospital passports. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital.
Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as working with people who have learning disabilities. Staff had also received training around the application of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The staff we spoke with understood the requirements of this Act and were ensuring that where appropriate this legislation was used.
Staff and people who used the service told us the home was run much like a large family. Staff shared with us a range of information about how they as a team worked very closely with people to make sure the service enabled each person to reach their potential. We saw on the corridor wall a ‘Reaching our dreams’ display. This pictorially showed the discussions people and staff had held around their goals for the year. We found that this plan was re-visited each year and a pictorial representation of the discussion was displayed for all to see. The display was very much artwork in its own right and a feature of the corridor wall.
People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that two staff were on duty during the day and one person provided sleep-in cover overnight. We found that the registered manager tailored the rota to people’s activities planner to ensure staff with relevant interests as skills such as jigsaw experts and swimmers were on duty when people planned to have these activities. We also found that they also altered the the times staff needed to start their shifts so they could with people to events in the evening.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
We reviewed the systems for the management of medicines and found that people received their medicines safely.
We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that staff would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home.
The registered provider had developed a range of systems to monitor and improve the quality of the service provided. We saw that the registered manager had implemented these and used them to critically review the service. We found that the registered manager had won national awards and they with the team had won nominations in the registered provider’s national competitions
We found that the registered provider was a strong advocate for the people who used their services. We found that each service had a service user representative who went to meetings at their headquarters. The person who used the service and undertook the role told us they were the voice of the people in the home and felt their views were listened to and acted upon.