11 December 2014
During a routine inspection
386 Lower Broughton Road is a care home in Salford which is registered to provide care for up to three people. It specialises in the care of people with either learning or mental health difficulties. At the time of the inspection the home was fully occupied.
We carried out our inspection of 386 Lower Broughton Road on 11 December 2014. At the previous inspection on 19 April 2013 we found the service was meeting all standards assessed.
There is a registered manager in day to day charge of the home. 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 staff we spoke with spoke positively about the management and leadership of the home. One member of staff said; “From day one I have been able to go to the manager with anything”.
We spoke with two people who lived at the home and one relative who either visited regularly or was in contact via the telephone. People living in the home told us they felt safe in the home and out in the local community. One person said, “I definitely feel safe living here. I get my medication and I know what it is for”.
We looked at how the service managed risk. We found individual risks had been completed for each person and recorded in their support plan. There were detailed management strategies to provide staff with guidance on how to safely manage risks and also ensure people’s independence, rights and lifestyle choices were respected.
People were protected against the risks of abuse because the home had a robust recruitment procedure in place. Appropriate checks were carried out before staff began work at the home to ensure they were fit to work with vulnerable adults. During the inspection we looked at three staff personnel files. Each file contained job application forms, interview notes, a minimum of two references and evidence of either a CRB or DBS (Criminal Records Bureau or Disclosure Barring Service) check being undertaken. This evidences to us that that staff had been recruited safely.
We looked at how the service ensured there were sufficient numbers of staff to meet people’s needs and keep them safe. We looked at the staff rotas. We found the home had sufficient skilled staff to meet people's needs. Staff spoken with told us any shortfalls, due to sickness or leave, were covered by existing staff which ensured people were looked after by staff who knew them. They also said staffing numbers were kept under review and adjusted to respond to people’s choices, routines and needs.
All staff were given training and support they needed to help them look after people properly. We observed staff being kind, friendly and respectful of people's choices and opinions. The atmosphere in the home was relaxed and the staff spoken with had a good knowledge of the people they supported.
People’s medicines were looked after properly by staff that had been given training to help them with this. Regular checks were done to make sure they were competent.
The Mental Capacity Act 2005 (MCA 2005) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The Deprivation of Liberty Safeguards (DoLS) provides a legal framework to protect people who need to be deprived of their liberty to ensure they receive the care and treatment they need, where there is no less restrictive way of achieving this. From our discussions with managers and staff and from looking at records we found all staff had received training about the MCA and DoLS. The manager and staff spoken with expressed a good understanding of the processes relating to DoLS.
People living in the home were involved in the planning of the menus and went shopping with staff to local shops and supermarkets each week. People, who were able to, were given support by staff to prepare their own meals. There was no set meal for lunch time and people living in the home were able to choose either to dine in or out of the house at a time convenient to them. The manager told us an evening meal was always prepared by staff and that people who lived at the home were able to contribute where possible. During the inspection we observed people entering the kitchen freely and making food of their choice when they wanted too. One person who lived at the home said; “The food is not bad”.
From looking at records, and from discussions with people who used the service, it was clear there were opportunities for involvement in many interesting activities both inside and outside the home. People were involved in discussions and decisions about the activities they would prefer which would help make sure activities were tailored to each individual. Activities were arranged for groups of people or on a one to one basis. Each person’s support contained a ‘weekly planner’ and set out the different types of things they liked to do during the weeks and at weekends.
The complaints procedure was displayed in the kitchen of the home and was also held on file. The procedure was available in an easy read format that could be understood by everyone who lived at the home. We looked at the complaints log and saw complaints had been responded to appropriately, with a response given to the individual complainant.
There were effective systems in place to regularly assess and monitor the quality of the service. They included audits of the medication systems, supports plans, money, fire safety, infection control and environment. There was evidence these systems identified any shortfalls and that improvements had been made. This would help to protect people from poor care standards. There was also a system in place to check staff competency with regards to medication. This was done in question format and tested staff on their knowledge of administration, PRN and what to look for in side effects.