Archived: Disabilities Trust - 1 Westfield Road

At the last comprehensive inspection on 21December, 2016 we asked the provider to take action to make improvements in relation to the systems in place to assess, monitor and improve the quality and safety of the services provided and this action has been completed.

At this inspection on 15 January 2018, we rated the service as Good.

There was 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.

People told us they felt safe and staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. People had risk assessments in place to cover any risks that were present within their lives, but also enable them to be as independent as possible. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by their manager.

Staffing levels were sufficient to meet people's current needs. The staff recruitment procedures ensured that appropriate pre-employment checks were completed to ensure only suitable staff worked at the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Staff were trained in infection control, and had the appropriate personal protective equipment to perform their roles safely. The service was clean and tidy, and regular cleaning took place to ensure the prevention of the spread of infection.

There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service

People’s needs and choices were assessed and their care provided in line with up to date guidance and best practice. They received care from staff that had received training and support to carry out their roles. Staff were well supported by the registered manager and senior team, and had one to one supervisions and observations of their practice.

People were encouraged to shop for, prepare and cook their own meals. Staff supported them to make healthy choices to maintain their health and well-being. Staff supported people to book and attend appointments with healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.

People’s diverse needs were met by the adaptation, design and decoration of premises and they were involved in decisions about the environment. People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. 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 support this practice

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and preferences. People told us they were happy with the way that staff spoke to them, and provided their care in a respectful and dignified manner. People were encouraged to make decisions about how their care was provided.

People were listened to, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred. Care plans were person centred and reflected how people’s needs were to be met. Records showed that people were involved in the assessment process and the on-going reviews of their care. They were supported to take part in activities, which they wanted to do, within the service and the local community. There was a complaints procedure in place to enable people to raise complaints about the service.

Systems were in place to support people and their families when coming to the end of their life. The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and honest, and improvements were highlighted and worked upon as required.

The service had an open culture that encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement. Staff were motivated to perform their roles and worked to empower people to be as independent as possible. The provider had quality assurance systems to review the quality of the service to help drive improvement.

Disabilities Trust - 1 Westfield Road is a residential care home which provides accommodation and personal care for people with high functioning learning disabilities or autism. The service is registered for up to three people and there were three people living there when we carried out our visit.

At our previous inspection on 21 December 2016 we found that one legal regulation was not being met. The quality assurance systems in place at the service were not sufficient to ensure the provider was able to assess, monitor and improve the quality of care at the service. Checks and audits which were in place were not carried out regularly or used effectively to ensure the quality of care at the service was monitored. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We asked the provider to send us an action plan to tell us how they intended to meet this regulation. They stated that they would have met it by 28 February 2017. We carried out this inspection to see if they had taken the action they reported they would.

We found that there had been improvements to the quality assurance systems in place at the service. Internal checks and audits were completed on a regular basis to identify areas for improvement and those which required updating. Action plans were implemented and the checks and action plans were supported by further checks by the provider to help monitor the service.

Disabilities Trust - 1 Westfield Road is a residential care home which provides accommodation and personal care for people with high functioning learning disabilities or autism. The service is registered for up to three people and there were three people living there when we carried out our visit.

There was 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.

There were quality assurance systems in place at the service however; these had not been robustly applied to ensure that the service was monitored and areas for improvement were identified and acted upon. We found there had been recent changes to management and senior staff personnel, which had an impact on the running of the service. However; the current staff and management team had started to address this in order to make improvements. There were systems in place to receive feedback from people, including complaints. These systems were not always robustly applied and there was a lack of consistency in the way that complaints were handled.

Risk assessments were in place at the service, however; these had not been updated recently. This meant that the risk assessments which were in place did not contain information about current risks or how to manage them. The provider had initiated action to review risk assessments so that they were up-to-date. Care plans had also not been regularly updated and contained information which was no longer relevant to people's needs and preferences.

People felt safe living at the service and staff were knowledgeable about abuse and the actions they should take to record and report it if they suspected abuse had taken place. Staff also knew about procedures for the safe handling and administration of people's medicines and had been trained to do so. Medication records were maintained and showed that medicines were given correctly. There were sufficient numbers of staff at the service to ensure that people's needs were being met.

There were systems in place to ensure that staff received regular training and development opportunities. In addition, they received supervisions to enable them to discuss any concerns they may have as well as their own development and that of the service.

Independence was promoted by the service and people were encouraged to make their own choices and decisions. People at the service had the mental capacity to make their own decisions, but the service had systems to ensure the Mental Capacity Act 2005 was followed if necessary. People were encouraged to prepare their own meals and drinks and were supported where necessary. They were also supported to book and attend appointments with healthcare professionals if required.

There were positive relationships between people and staff. Staff members had spent time getting to know people and their specific needs and preferences. People were treated with kindness and compassion and staff were active in promoting people's privacy, dignity and respect. They had been involved in the writing of their own care plans and were provided with important information about their care and the service.

The service had a positive culture and clear person-centred ethos. People were encouraged to take part in activities of their own choice and were supported by the service to develop their independence.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive to people's needs?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

The three people living at 1 Westfield Road indicated to us they were happy and felt safe living at the home. One person said of the staff, 'They are all nice.' People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The staff were knowledgeable about people's care and support needs and there were sufficient staff on duty to provide the necessary care for people using the service. We saw regular checks of the environment were made to ensure any faults were identified and rectified in a timely fashion.

Is the service effective?

We observed staff support people in line with their assessed needs. Support plans had been updated when people's needs had changed and people were helped to attend a variety of different activities. People were supported to attend medical appointments and to make positive 'healthy living' choices to remain in good health.

Is the service caring?

During our visit we observed good interactions between the staff and the people using the service. People were provided with choices and supported to make appropriate decisions about their care. The staff we spoke with had good knowledge about people's medical conditions and support needs. Where people needed staff support in the community this was done in a unobtrusive manner so as not to compromise a person's dignity.

Is the service responsive to people's needs?

We observed that staff interacted well with the people who used the service. We saw support plans had been updated when people's needs had changed, and referrals had been made to other health and social care professionals when needed. The staff rotas took account of peoples social needs, and additional staff were rostered as required to support people using the service with social activities.

Is the service well-led?

The service had a manager working on a day to day basis at the service. This person was currently going through the registration process with CQC to become the registered manager of the service. Staff told us the manager was approachable and supportive.

Documentation confirmed that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives, and took account of the findings to improve the service.

One person using the service told us that they were happy living at the home. They told us that the staff were very nice and 'They talk and listen to me and take me to Oxfam' a work placement that they enjoyed helping out. They also told us that the staff did activities with them and they enjoyed this. They also told us that they knew how to make a complaint to the staff if they had any concerns. However they told us that they had no complaints and they liked living at the home. They also told us that the food was very good and they helped staff with food shopping.

We observed staff working and communicating well with people using the service. They told us that there were enough staff to meet the needs of the people and well supported by management to carry out their role.

People’s needs were assessed and care and support was planned and delivered in line with their individual care plan. People using the service told us the care and support provided at the home was good and that they got on well with staff who were helpful and listened to them.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were not enough qualified, skilled and experienced staff to meet people’s needs at all times.People were being cared for by a mixture of permanent, bank and agency staff. Staffing numbers were due to be increased during the day and recruitment to permanent posts was underway.

There was an effective system to regularly assess and monitor the quality of service that people receive. A programme of regular audits is undertaken with action taken to remedy any areas for improvement.