Background to this inspection
Updated
3 September 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 5 August 2016 and was announced. The provider was given 72 hours’ notice because the location provides a short stay service to give people and their carers a break and we needed to be sure that the service would be open.
The inspection was carried out by one adult social care inspector.
Before the inspection we reviewed all of the information we held about the service, this included reviewing notifications we had received. A notification is information about important events which the service is required to send to the Commission by law.
We contacted the commissioning and contracts officer for the service. They had not visited for some time but shared their last assessment visit record with us. We used this to inform our inspection planning.
During the inspection we spoke with the registered manager, a team leader, member of domestic staff and a support worker. Following the inspection we spoke on the telephone with a further three support staff and two team leaders.
We spoke with two people who used the service and because not everyone could tell us their views we spent time observing interaction between people and care staff. We spoke with three visiting relatives. Following the inspection we spoke on the telephone with one relative.
We carried out a tour of the premises which included communal areas and bedrooms. We reviewed four people’s care plans and associated records. We looked at medicine administration records.
We reviewed records associated with the running of the service such as staff files, audits, rota’s and staff meeting minutes.
Updated
3 September 2016
This inspection was announced and took place on 5 August 2016. At the last inspection in April 2014 we found the service was meeting three out of five regulations we assessed. The service was not meeting the following regulations; consent to care and treatment and assessing and monitoring the quality of service provision. We followed this up with an inspection in August 2014 and found the service had taken action to make improvements and was meeting the regulations.
The service offers short breaks to people with learning disabilities and autism. It provides personal care and accommodation for up to seven people. In total 15 people accessed short breaks at the service on a regular basis.
At the time of our inspection there were four people staying at the service. Three people were on a planned short break and one person had come to stay due to a family emergency.
The service had a registered manager in post. 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.
The service had completed some detailed best interest decisions to ensure people received effective care. However, we did not see evidence of mental capacity assessments to show why people lacked the ability to make their own decisions. This meant the service was assuming people lacked the capacity to make a decision without following the principles of the Mental Capacity Act 2005 (MCA). DoLS were appropriately referred for. We have made a recommendation about following the principles of the MCA.
The registered manager and staff team knew how to protect people from avoidable harm. Staff were aware of the different types of abuse and how to report concerns to ensure these were investigated effectively. Staff were aware of individual risks to people and what they needed to do to keep people safe.
There were sufficient staff to keep people safe when the service was open. However, due to challenges of staff recruitment and retention the availability of the service had reduced and this had caused some concern for families and the staff team.
Medicines were safely managed. The staff team had received regular training to ensure they were competent to administer people’s medicines.
Staff were provided with a detailed induction and had access to a range of training. This training covered standard training topics and more specialised training was provided, based on the needs of people who stayed at the service.
People’s food preferences were taken into account and adapted crockery and cutlery was available to support people to be as independent as possible.
Although the environment was not purpose built it was evident the needs of people who stayed at the service were taken into account. For example specialist equipment and adaptations had been made to support people.
Staff knew people and their families well. This meant they were able to deliver care which ensured people’s preferences were met. Staff respected people’s dignity and privacy. All of the staff we spoke with said they would be happy for their relative to stay at the service.
People were supported to be as independent as possible. The service had a separate living area which could be used to support people to develop daily living skills such as cooking, cleaning and laundry.
Care plans provided staff with detailed information about each individual, what was important to them and how they would like to be supported. The service responded to people’s changing needs and sought advice and support from relevant health and social care professionals.
People were supported to access a range of activities. Staff arranged events at the service and invited a variety of community resources to raise the profile of the service. The provider sought the views of people who used the service and their relatives and took action in relation to suggested improvements
The registered provider had a complaints policy in place and people we spoke with knew how to raise concerns and were confident these would be investigated and resolved. The service had systems in place to evaluate the service and to ensure quality care was provided.