Kingston upon Hull City Council - 220 Preston Road

The premises is set out over two floors with individual bedrooms and communal bathrooms.

We found the following examples of good practice.

The premises were clean and hygienic with increased cleaning schedules including deep cleaning and regular cleaning of high touch surfaces.

The provider had implemented additional risk assessments for people using the service and staff who could be at increased risk of complications from contracting COVID-19.

The provider managed staff cohorts well to reduce the risk of transmission of infections within the premises.

The provider engaged well with health care professionals to monitor the health and wellbeing of people using the service during an outbreak of COVID-19.

People’s experience of using this service: The management team were extremely good at planning and delivering care that was tailored to people’s individual needs and preferences. People’s care plans truly reflected their individual needs, interests, wishes and aspirations. This was a huge improvement from the last inspection, where care plans were disjointed and information was difficult to find. The end of life care for one person was delivered in a very compassionate way, which responded to their needs and the needs of relatives and friends. There was a thoughtful and inclusive approach to organising interesting and meaningful occupations and activities for people, which enhanced the quality of their lives.

People lived in a safe environment. Staff knew how to protect people from abuse and harm; risk assessments were completed, which helped staff minimise risk whilst ensuring this was not overly restrictive. Staff were recruited safely and there was enough staff deployed to meet people’s needs. Staff received training and supervision, which provided them with the skills and knowledge to support people safely and effectively.

People’s health and nutritional needs were met. Staff supported people to access health professionals when required; people received their medicines as prescribed. The menus offered people choices and alternatives.

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 supported this practice.

The staff approach was kind and caring. They respected people’s privacy and dignity and supported them to be as independent as possible.

There was a quality monitoring system which consisted of audits, meetings and questionnaires to make sure people’s views were obtained and action could be taken when shortfalls were identified. People felt able to raise concerns or make a complaint. Information about how to complain was in an accessible format.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection: Requires Improvement (the last report was published on 11 April 2018)

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

220 Preston Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

220 Preston Road accommodates up to 10 young adults who have a learning disability and autism. The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The service has two floors accessed by stairs and is divided into two separate areas with five single bedrooms, a bathroom, a shower room, a sitting room and dining room in each one.

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.

We found some areas of the environment posed a potential risk to people. These included damaged items of furniture, a leaking toilet, some cleanliness issues and low temperature of the hot water outlets. You can see what action we told the provider to take at the back of the full version of the report.

People who used the service had an assessment of their needs, risk assessments and a care plan. There was an inconsistency in the care files with some people having good, informative care plans for specific areas whilst other had basic plans, which lacked update. We have made a recommendation about reviewing the care files to address shortfalls.

There was a quality monitoring system in place, which consisted of audits, checks, surveys and meetings. We found some shortfalls in the auditing of the environment and addressing issues in a timely way. The registered manager told us they would monitor cleaning schedules more thoroughly and ensure shortfalls were addressed quickly.

Staff knew how to safeguard people from the risk of harm and abuse. They had completed training and knew how to raise concerns.

Staff had been recruited safely. There were sufficient numbers of staff on duty at all times, and with an appropriate skill mix, to meet people’s assessed needs. Staff had access to induction, training, supervision and support, which enabled them to feel skilled when supporting people who used the service. Additional training had been delivered to the staff to equip them with skills and approaches when supporting one person with anxious and distressed behaviour.

We observed staff had a kind and caring approach. They knew people’s needs very well and supported them to maintain independence, privacy and dignity. Staff also supported people to make their own decisions as much as possible in order to maintain their human rights. They ensured that when people lacked capacity, they included relevant people in best interest decision-making.

Medicines were stored safely and administered to people as prescribed. There was a shortfall in stock control, which had led to avoidable wastage of some medicines. This was mentioned to the registered manager to address.

People’s health care needs were met and they had access to community health care professionals when required. The registered manager and staff team had developed good working relationships with health colleagues. This had resulted in planned discussions about treatment options and had been supportive of people who used the service when they required treatment.

People’s nutritional needs were met. Menus provided them with choices and alternatives. Staff contacted dieticians and speech and language therapists in a timely way when they had concerns.

There was a range of meaningful occupations and activities for people to participate in and planned visits to local facilities were completed.

The provider had a complaints policy and procedure and staff knew how to manage complaints. Relatives told us they felt able to raise concerns if required. All three relatives spoken with described an open culture and accessible management. They were happy with the service their family member received.

We found improvements had been made in the way staff supported people to maintain their personal hygiene. Risk assessments had been completed to determine the risk of people accessing hot and cold water without staff support and adjustments to sinks in bedrooms and toilets had been made.

We found domestic hours had been increased, which ensured there was sufficient staff available to clean and tidy the service.

We observed staff speaking to people in a kind and caring way. We also observed them asking people rather than telling them what to do. We saw that people were encouraged to make their own decisions about day to day activities. When important decisions were required for people staff ensured best interest meetings were held and family consulted.

We found people had choices about the meals they ate and their nutritional needs were met. Staff provided support to people when eating and drinking in line with their assessed needs.

We found that shortfalls in the amount of domestic staff meant some areas of the home had not been cleaned effectively. We also found systems to prevent the spread of infection could be improved.

We found there were sufficient numbers of staff on duty to support people's needs. Staff had access to training and supervision and told us they were well supported. Comments included, 'We have loads of training' and 'We have a good team that is happy and upbeat.' A visiting health professional told us staff had been skilled in supporting people and always contacted them when required.

We found people were able to express their views about the service via daily activities of living, surveys and meetings. Audits and checks were completed to monitor quality, although we found some of these could be improved.