27 July 2017
During a routine inspection
At this inspection we found the service remained Good in four of the key lines of enquiry and had improved to an Outstanding rating in Caring. Overall the rating has remained as Good.
Old Oak Road is a six bedded care home for male and female adults with a learning disability, and there was one vacancy at the time of the inspection. The home has two bedrooms on the ground floor and four bedrooms on the first floor, with a passenger lift to connect the two floors. The bedrooms do not provide en-suite facilities; however there are communal bathrooms and toilets on each floor. There are other communal areas, including a combined lounge, dining room and rear garden.
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 registered manager was present at the inspection and has managed the service for over 20 years.
The provider was outstanding in regards to the caring and compassionate way that staff supported people who use the service. People, relatives and external health and social care professionals stated that staff were exceptionally kind and respectful at all times. Throughout the inspection we observed that staff were committed to providing people with support and encouragement to enable them to lead enriched and fulfilling lives. People’s dignity and independence was promoted, and their achievements were positively recognised by the registered manager and the staff team. Actions had been taken by staff to gently and sensitively support people following a recent bereavement.
People using the service told us they felt safe living at their home and they trusted the staff to protect them from harm and/or abuse. Some people could not verbally express their views; however we observed that interactions between people and staff were warm and friendly. Staff were familiar with the provider’s safeguarding adults’ policies and procedures, and had received relevant training.
Detailed and up to date risk assessments had been developed to provide staff with appropriate guidance to support people in a safe manner, whilst promoting people’s independence and taking into account their wishes and choices. Staff understood their responsibilities in regards to ensuring that people’s medicines were safely stored and administered, and properly disposed of if necessary. Records showed that staff had up to date medicines training.
We saw that sufficient staff were deployed to ensure people received support with their personal care, and the support they needed to participate in their favoured social and recreational activities at home and in the wider community. During the inspection people went out as planned with staff to their chosen activities, which included restaurant trips, clothes shopping and a visit to a barber shop. The provider adhered to robust recruitment practises to make sure that newly appointed staff had suitable skills and knowledge to provide safe care and support.
Staff were supported with their training and development needs. The provider’s training programme was tailored to enable staff to meet mandatory training requirements and undertake training that specifically addressed people’s individual health care needs. Systems were in place to provide staff with individual and group support, for example staff attended one to one formal supervision sessions and regularly held team meetings.
People using the service were supported by staff to participate with the planning and preparation of their meals and snacks. Staff consulted people every week about the proposed grocery shopping list and the menu plan. We saw that staff discretely supported people who needed assistance with eating and drinking.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is necessary to restrict their freedom in some way, to protect themselves or others. We noted through discussions with staff and by looking at records that staff had received appropriate training about how to protect people’s rights.
People’s care and support plans showed that their health and social care needs had been comprehensively assessed before they moved into the service and these assessments were used in order to develop individual care and support plans. Clear processes had been implemented to ensure that people were supported to meet their identified needs. For example people were supported to visit health care professionals including GPs, practice nurses, psychologists and dentists, and people’s health care needs were explained in straight forward terms within their health action plans.
The provider had produced documents in an easy read format for people who use the service, so that staff could support them to understand their rights and entitlements. The people we spoke with during the inspection and relatives knew how to make a complaint and they expressed full confidence in the registered manager’s ability to investigate and resolve any concerns in a professional and supportive manner.
Relatives commented on the dedicated and approachable manner of the registered manager. Staff described the registered manager as being an inspiring and motivating role model, who consistently led by example. There was a strong ethos of empowering people who use the service and supporting them to participate wherever possible in the daily management of the service. People’s views and the views of their chosen representatives were sought and acted on as part of the provider’s quality monitoring systems. The service worked well with a range of external organisations that supported people using the service to meet their various health and social care needs. Complimentary opinions written by local health and social care professionals had been gathered by the provider as part of its own quality assurance processes.